✨ Election Nomination Form
NEW ZEALAND GAZETTE, No. 102 — 5 OCTOBER 2017
Election nomination form
This form is to nominate a parent representative on to a school board. The nominator must be on the roll for the election, otherwise the nomination is invalid.
Send this nomination form to <
No later than 12 noon on Friday 17 November 2017
SCHOOL DETAILS
| School name | |
| School profile number |
CANDIDATE DETAILS
| Full name | |
| Phone |
For statistical purposes only, candidates are requested to complete the following
Gender
○ M ○ F ○ Other
Previous experience
Please tick any applicable
○ Current representative standing for re-election
○ Current co-opted or appointed board member standing for election
○ Not a current member but have previously been a member of a school board
○ No previous board experience
○ Other __
Ethnicity
Which ethnic group or groups do you identify with?
(select up to three)
○ NZ Māori ○ Asian ○ Pasifika
○ European (including NZ European/Pākehā) ○ Middle Eastern/Latin American/Africa (MELAA)
○ Other ○ Not stated
If you have selected Pasifika, Asian, MELAA or Other, please provide a further breakdown of the ethnicity identified, if known __
I declare that I have read and understood the ineligibility criteria for school trustees, under section 103 of the Education Act 1989 (ineligibility criteria are on the reverse of this page), and declare that I am eligible to become a trustee. I hereby consent to the above nomination and declare that all other information that I have listed on this form is true and correct.
Dated __
(Signature of candidate)
NOMINATOR DETAILS
| Full name | |
| Address | |
| Phone number |
Dated __
(Signature of nominator)
69
Next Page →
NZ Gazette 2017, No 102
✨ LLM interpretation of page content
🎓 Nomination form for school board parent representative
🎓 Education, Culture & ScienceNomination, School board, Parent representative, Election, Education Act 1989