2012 Nomination Form
For the Chapter Leadership Council - Sarnia Lambton Chapter
Nominee Information:
Name: ___________________________________________
Phone: ________________________ Email: _____________________________
Nominated By:
Name: ___________________________________________
Signature: _____________________________ Date: _____________________
Phone: _________________________ Email: _______________________________
Supported By:
Name: _________________________________________
Signature: ____________________________ Date:
Phone: ___________________________ Email: ______________________________
Brief Biography of Nominee:
Please provide information that directly supports the reasons you think your nominee will be an asset to the Sarnia Lambton Chapter's Chapter Leadership Council. This information will be mailed out to all members-in-good-standing of Sarnia Lambton Chapter.
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Mail to: Autism Ontario - Sarnia Lambton Chapter
1086 Modeland Road
Sarnia, ON N7S 6L2
Email to : chaptermgr.sarnia@autismontario.com
Attention: Tania Whyte, Manager Chapter Development & Fundraising
Note: Nominee must be willing to allow his/her name to stand for election.