2020/2021 NAWIC AGM and Election - Nomination Form Question Title * 1. Please select a chapter ACT NSW QLD VIC WA SA NT TAS NATIONAL Question Title * 2. Personal details First Name * Last Name * Address City/Town * State/Territory * Postal Code * Country * Email Address * Phone Number * Question Title * 3. Membership ID number (or type 'Membership Pending' If you do not have a NAWIC membership) Question Title * 4. Nominee Name (You can enter your own name or another members name) Question Title * 5. For the position of: Office Bearer Committee Chair Committee Member Any of the above Please specify the position: (eg: vice president, sponsorship chair) Question Title * 6. Declaration: I confirm that I have read and I agree to abide by the NAWIC Chapter Code of Conduct. Yes - I declare Question Title * 7. Declaration: I confirm that I am a current member of NAWIC (or will sign up to become a NAWIC member) and acknowledge that by submitting this electronic nomination I agree to abide by the NAWIC Chapter Management Policy for Chapter Council Elections. Yes - I declare Done