Nomination Form

SeniorNet Association Inc.
PO Box 559 Booval 4304
ABN 95 360 623 241

  ELECTION OF *PRESIDENT OF SeniorNet Association Inc.
or
*OFFICE BEARER

(*Select one from above)
We, the undersigned members of SeniorNet Association Inc. Ipswich propose/second:

FIRST NAME ________________________________________________________

FAMILY NAME_______________________________________________________

  For the election to the position of President of SeniorNet Association Inc. for 200

  Dated this_________________ day of _______________________200

Proposer:       _______________________   Signature:    ___________________
                       Please print    

  Seconder:      _______________________   Signature:   ____________________
                         Please print

I consent to be nominated ____________________________________
                                                         Signature of Candidate

  Nominations close with
Returning officer,

Seniors helping seniors use computers and the Internet
SeniorNet Association Inc. Sponsored by iTEL Community Telco Ltd., Incorporating Global Info-Links