FEDERATION OF GAKEM STUDENTS ELECTORAL COMMISSION

2023
(FEGASEC’23)

NOMINATION FORM FOR PROSPECTIVE FEGAS EXECUTIVE

Write all fields in block letters

NAME OF ASPIRANT:

Surname Last Name Middle Name

RESIDENTIAL ADDRESS:

COMMUNITY/UNIT OF ORIGIN:

PHONE NUMBER:

GENDER: DATE OF BIRTH:

DD/MM/YYYY
POSITION VYING FOR:

NAME OF INSTITUTION:

FACULTY/DEPARTMENT:

CURRENT ACADEMIC LEVEL: YEAR OF GRADUATION: CURRENT CGPA:

HAVE YOU HELD ANY POSITION IN FEGAS: IF YES SPECIFY:

NAME OF REFEREE 1:

PHONE NUMBER OF REFEREE 1:

NAME OF REFEREE 2:

PHONE NUMBER OF REFEREE 2:

REASONS FOR CONTESTING:

1.

2.

3.

I _____________________________________________________hereby attest that the information

provided above are true and if found to be false, I shall be disqualified from the race of contesting for
any position I am vying for. I also understand that the amount for this form is non-refundable. In
situations where I violate the election guidelines as stipulated in the FEGAS constitution and/or by
FEGASEC, all necessary disciplinary action shall be meted on me.

Affix Recent
Passport
______________________
Sign/Date

FOR OFFICIAL USE ONLY

SCREENING OFFICERS:

1.______________________________________________________________SIGN:________________

2.______________________________________________________________SIGN:________________

3.______________________________________________________________SIGN:________________

4.______________________________________________________________SIGN:________________

5.______________________________________________________________SIGN:________________

ASPIRANT ACCEPTED

ASPIRANT REJECTED