MISA ZAMBIA 2008 AGM CANDIDATURE FORM
NAME: ____________________________________________________________________________ ___ AGE: ____________________________________________________________________________ ___ POSITION ASPIRED FOR : ____________________________________________________________________________ ___ WHEN DID YOU BECOME FULLY PAID UP MEMBER OF MISA ZAMBIA? ____________________________ NAME OF ORGANISATION YOU WORK FOR: ____________________________________________________________________________ ________
POSITION HELD : ____________________________________________________________________________ _________ PREVIOUS POSITION HELD:_______________________________________________________________________ ________ BRIEF BACKGROUND ABOUT YOURSELF:__________________________________________________________________ _________
EDUCATIONAL QUALIFICATIONS: ____________________________________________________________________________ _________
EXPERIENCE IN THE MEDIA: ____________________________________________________________________________ _________ ORGANISATIONAL/ LEADERSHIP ABILITIES:
WHAT WILL YOU DO FOR MISA ZAMBIA?
SIGNATURE : ____________________________________________
DATE : __________________________________________________
NB: ADDITIONAL INFORMATION SHOULD BE WRITTEN ON A SEPARATE PIECE OF PAPER.
The forms may be hand delivered to the MISA Secretariat on Plot number 3814, Martin Mwamba RD. Olympia Park, Lusaka or faxed to 292096, 294285, 294286