Elections 2016/Nominations/Dr Subas Chandra Rout
Nomination form for Wikimedia Chapter Executive Committee Elections-2016
(To be initiated by Proposer and updated by Seconder and the Candidate wishing to contest for Election and submitted as per the due date)
Name of the candidate: Dr Subas Chandra Rout
Membership ID (can be updated by Candidate later): INDI-652
Member Since (can be updated by Candidate later):________
(As per Wikimedia Chapter by-laws, a Member for election to Executive Committee should have been member for at least 3 months before the date of the meeting of the AGM/Election).
Membership ID: INDI-11
Signature(Use Wiki Signature):____________________________
Acceptance by the Candidate
Short Profile* (including past involvement in Wikimedia activities in not more than 100 words):
Position Statement/Letter of intent* (in not more than 200 words):
Conflict of Interest disclosure (if any)
I____________________________ solemnly affirm to hold the aims and objectives of Wikimedia Chapter in highest esteem and strive to the best of my ability in serving the cause of Wikimedia Chapter.
Signature(Use Wiki Signature):_______