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:

MEMBERS OF THE SCOTTISH DISABLED MEMBERS COMMITTEE (8)

4 of which must be women.

Our Branch wishes to nominate for the position of MEMBER of the Scottish Disabled Members Committee:

Nomination (1)

NAME:

 

ADDRESS:

 
   
   

SERVICE GROUP:

 

 

NAME OF BRANCH:

 

 

Nomination (2)

NAME:

 

ADDRESS:

 
   
   

SERVICE GROUP:

 

 

NAME OF BRANCH:

 

 

Nomination (3)

NAME:

 

ADDRESS:

 
   
   

SERVICE GROUP:

 

 

NAME OF BRANCH:

 

 

Nomination (4)

NAME:

 

ADDRESS:

 
   
   

SERVICE GROUP:

 

 

NAME OF BRANCH:

 

 

Nomination (5)

NAME:

 

ADDRESS:

 
   
   

SERVICE GROUP:

 

 

NAME OF BRANCH:

 

 

 

 

 

Nomination (6)

NAME:

 

ADDRESS:

 
   
   

SERVICE GROUP:

 

 

NAME OF BRANCH:

 

 

Nomination (7)

NAME:

 

ADDRESS:

 
   
   

SERVICE GROUP:

 

 

NAME OF BRANCH:

 

 

Nomination (8)

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:

SDMC MEMBER

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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