Standing Independent Selection Panel (SISP) Industry Representative - Candidate Nomination Form
Due 21 October 2016
Name of Ordinary Member – organisation name
Print Name (Authorised Signatory)
Position (Authorised Signatory)
Signed by Authorised Signatory on behalf of Ordinary Member
Dated
Hereby nominates the following person as a Candidate for Election to the Standing Independent Selection Panel (SISP):
Print Full Name (Nominee) Address (street address)
Phone Mobile Email
I hereby consent to the above nomination as a Candidate for Election to the Standing Independent Selection Panel (SISP):
Print Name
Signed by (Nominee)
Dated
Nominees: Please attach a brief Resume of relevant credentials and address the selection criteria (maximum 3 pages). Please note information from these documents will be circulated to the Members so details in these documents should be kept to information related to this application. Once completed, return to Terrain by post to PO Box 1756, Innisfail Qld. 4860, fax 07 4220 9455 or email colleen.mcintosh@terrain.org.au.