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Elections 2016/Nominations/Dr Subas Chandra Rout

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Revision as of 02:22, 22 March 2017 by Odisha1 (talk | contribs) (Name corrected)

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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)

Proposal details

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).


Proposer:

Name:Srikant Kedia

Signature(Use Wiki Signature): Odisha1 (talk) 23:35, 20 March 2017 (IST)

Membership ID: INDI-11


Seconder:

Name:_____________________

Signature(Use Wiki Signature):____________________________

Membership ID:______

Acceptance by the Candidate

Short Profile* (including past involvement in Wikimedia activities in not more than 100 words):

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Position Statement/Letter of intent* (in not more than 200 words):

_____________________________________________________________________________________________________

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Conflict of Interest disclosure (if any)


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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.

Place:________

Date:_________

Signature(Use Wiki Signature):_______

Name:________________