BGM 2012 Nomination & Withdrawal form

Karnataka & Goa Unit, I floor, C.R.Bldg.Annex., Queen’s Rd., Bangalore – 560 001.

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GENERAL BODY ELECTIONS - 2012

NOMINATION FORM

1. Name of the Post                                                :

2. Name and designation of the Contestant               :

3. Name & designation of the Proposer                     :

4. Signature with date of the Proposer                     :

5. Name and designation of the Seconder                  :

6. Signature with date of Seconder                           :

7. Signature with date and station of the Contestant :

Karnataka & Goa Unit, I floor, C.R.Bldg.Annex., Queen’s Rd., Bangalore – 560 001.

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GENERAL BODY ELECTIONS - 2012

WITHDRAWAL FORM

I,---------------------------------------------------------------, withdraw my nomination on my

free will  for the post of -------------------------------------------------------------.

(Post for which the contest wishes to withdraw)

Signature      :

Date             :

Station         :