COLLEGE OF AGRICULTURE, SCIENCE & EDUCATION

P.O.BOX 170, PORT ANTONIO, PORTLAND

Tel: 1876 9935401 0r 1876 579-5557
Student Council and Hall Committee Nomination Form

Candidate Information

Post being nominee ______________________________________________

Candidate: ________________________________________________________________

Telephone Number_______________________ Email Address _____________________________

Faculty: __________________________________________________________________________

Year Group: ______________________________________________________________________

Residential _____ Non Residential _______

Dormitory: Room # : Level:

Witness (1) Student’s Name and ID: ___________________________________________________

Signature: _______________________________________________________________________

Witness (2) Student’s Name and ID: ___________________________________________________

Signature: ________________________________________________________________________

Candidate’s Signature ________________________________________________________________

Nomination fee of $300.00 Paid Yes ________ No _________

Official Signature Director of Student Affairs: ___________________________________________

Date Received: