Candidate Nomination Form

Proposer's Name *

Proposer's Email Address *

Proposer's Phone Number *

Proposer's Location *

Candidate's Full Name *Candidate's first name and surname

Candidate's Phone Number *

Candidate's Country of Residence *

Candidate's Chapter/Branch *

Candidate's Proposed Elective Position *

Candidate's Statement of Acceptance *I accept this nominationI confirm that the information supplied in this form is accurateI agree to comply with DIAA ConstitutionI consent to the verification of my attendanceI agree to conduct my campaign peacefully and respectfullyI understand that no elected officer shall serve more than two terms

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