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NOMINATION FORM

Full Name ____________________________________ Building & Apt. # _____________________


Email _______________________________________ Phone _____________________________

I AM INTERESTED IN RUNNING FOR THE OFFICE OF:


President ______

Vice President ______ (check only one here)

AND / OR
Common Council Representative ______

PLEASE CHECK ALL:

______
______ I have resided on Roosevelt Island for 1 or more years (only for President or Vice President nominees)
______ I am 18 years of age or more
______
______ I testify that I will serve the RIRA Common Council with respect
______ I answered all questions and information truthfully
Note: you do not need to be a U.S. citizen to nominate yourself, vote and participate in RIRA.

CANDIDATES FULL NAME ________________________________

_______________________
(Signature)

TUESDAY OCTOBER 25 2016, 9PM.


For additional information, do not hesitate to call Adib Mansour (646) 283-4973 - riradib@earthlink.net

MEMBERSHIP:

RESPONSIBILITIES OF RIRA OFFICERS AND COMMON COUNCIL MEMBERS:


PRESIDENT:

VICE PRESIDENT:

*President & Vice-President candidates should submit to the WIRE by 5 PM, Oct.27, a campaign statement (max. 800
words) and a photo headshot for publication in the Nov. 5 issue. (WIRE editor will take your picture, if needed). We will
send you a reminder once we receive your Nomination Form.
COMMON COUNCIL MEMBERS:
-

order to continue to comply with such Section.


ALTERNATES:

RIRA NOMINEES SHOULD ATTEND THE FOLLOWING CANDIDATES NIGHTS: