First name
Last name
Email
Mobile
1.
What election is this nomination for?
DCWP Inspector Chapter
2.
Are you nominating yourself?
Please select
Yes
No
3.
What is the full name of the person you are nominating?
4.
What is the mobile phone number of the person you are nominating? (if you know it)
5.
What is the personal email address of the person you are nominating? (if you know it)
6.
What position are you nominating this person for?
Please select
Chairperson
Vice-Chairperson
Secretary
7.
Would you like to submit a candidate bio or statement? (max 250 words)