Please print this form and send to the address below

SCOTTISH DISABLED MEMBERS SELF ORGANISED GROUP

ANNUAL FORUM

SATURDAY 15 JANUARY 2005

STUC OFFICES, 333 WOODLANDS RD, GLASGOW G3 6NG

 

NOMINATION FORM:

REPRESENTATIVE ON THE NATIONAL DISABLED MEMBERS COMMITTEE (2)

One of which must be a woman

 

Our Branch wishes to nominate for the position of REPRESENTATIVE ON THE NATIONAL DISABLED MEMBERS COMMITTEE:

Nomination (1)

NAME:

 

ADDRESS:

 
   
   
   

SERVICE GROUP:

 

 

NAME OF BRANCH:

 

 

 

 

Nomination (2)

NAME:

 

ADDRESS:

 
   
   
   

SERVICE GROUP:

 

 

NAME OF BRANCH:

 

 

 

 

 

SIGNATURE OF BRANCH SECRETARY:

 

Please use the attached sheet (if you wish) to provide a supporting statement.

Return forms to Eileen Dinning, Scottish Women's Officer, UNISON House, 14 West Campbell Street, Glasgow G2 6ER by Friday 24 December 2004

SCOTTISH DISABLED MEMBERS SELF ORGANISED GROUP

ANNUAL FORUM

SATURDAY 15 JANUARY 2005

STUC OFFICES, 333 WOODLANDS RD, GLASGOW G3 6NG

NOMINATIONS: SCOTTISH DISABLED MEMBERS COMMITTEE

SUPPORTING STATEMENT

POSITION:

NATIONAL DISABLED MEMBERS COMMITTEE REPRESENTATIVE

NAME:

 

BRANCH:

 

Details as follows:

 

 

 

 

 

 

 

 

 

 

 

Return forms to Eileen Dinning, Scottish Women's Officer, UNISON House, 14 West Campbell Street, Glasgow G2 6ER by Friday 24 December 2004

 

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