Hornsby Shire Council

Attachment to Report No. CC86/08 Page 0

NOMINATION FORM

HORNSBY SHIRE COUNCIL DEPUTY MAYORAL ELECTION 2008

TO BE HELD ON 8 OCTOBER 2008

We, Councillor ............................................................................................................

(name in full)

and Councillor ............................................................................................................

(name in full)

elected members of the Hornsby Shire Council hereby nominate

Councillor ............................................................................................................

(name in full)

as a Candidate at the abovementioned election.

Signed ................................................

Signed ................................................

Date .................................................... day of 2008

I, Councillor ............................................................................................................ hereby

(name in full)

consent to such nomination.

Signed ................................................

Date .................................................... day of 2008