VGN - Worker Representative Nomination Form

Worker Representative Nomination Form
Nominator Details

Your Details
Name*

First NameLast Name
Department*
Job Title*
Signature*

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Date*

DayMonthYear
Date
Nominee Details

Details of the person that you are nominating
Name*

First NameLast Name
Department*
Position*
Nominee Consent
I, (name)* agree to be nominated as a Worker Representative and understand the roles and responsibilities associated within this position.
Signature*

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Date*

DayMonthYear
Date
Should be Empty:

Worker Representative Nomination Form