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CANDIDATE NOMINATION FORM
MUST BE FILED ONLINE BY MARCH 10, 2022 AT 1:00 P.M.
Part I – Candidate’s Information
The name appearing in the boxes below must be exactly as the candidate wishes their name to appear on the ballot paper. One or more of the given names of the candidate may be replaced by the nickname by a normal aberration of one or more of the candidates given name (i.e. Meg, Andy, Bill). Mononyms are not accepted on the ballot, unless that the mononym is the legal name of the nominee.
Name
*
Given Name
Surname
If your name by which you are registered at Durham College is different than the name which you wish to have appear on the ballot paper please give your legal name here:
Given Name
Surname
This name will not appear on the ballot paper but will be used to verify your status as a student with the college.
Student Number
*
Position sought
*
Class B - Justice and Emergency Services
Class E - Science and Engineering Technology
Class F – Hospitality and Horticultural Science
Part II – Contact Information
This information is collected for the use of the election services department. It is not used by third parties.
Cell Phone
Other Phone
Durham College Email address
*
Preferred Email
(if different than the college)
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Part III – Candidate’s Consent to Nominations
I, the above named candidate, the nominee in this nomination paper, do affirm that: - I consent to the nomination - I am a qualified elector and I am eligible to be a candidate for the position which I seek; - I am aware of the obligations imposed on me as a candidate in the by-laws and Elections Policy; and - My name as recorded in Part I, is exactly how I wish my name to be spelled on the ballots.
I, the above named candidate, further agree to the disclosure of personal information regarding my academic standing held by the Office of Strategic Enrolment Services of Durham College of Applied Arts and Technology to the Chief Returning Officer for the purpose of determining my eligibility to run for an position. I consent to disclosure of my academic information in accordance with section 42(1)(b) of the Freedom of Information and Protection of Privacy Act (RSO 1990, C. F-31).
Candidate’s Constent
*
I agree and confirm that all submitted information is true and accurate.
Email
This field is for validation purposes and should be left unchanged.
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