Trinbarjam Elections-Nomination Form

2023

ARE YOU QUALIFIED?!?!

Before filling out this form please ask yourself the following questions:
 Am I over the age of eighteen (18)?
 Do I have any record of past criminal activities?
 Do I have secondary passes in 8 CXC subjects including passes in Mathematics
and English?
 Am I a legal citizen of the country?

If you have answered yes to the following questions, GREAT NEWS!! You are
qualified to participate in the elections.
Brief Description Of the Form
In this form you will have to give us your:

 Full name
 Sex
 Date of Birth
 Which Party you are representing
 Some personal and background information
 And a small message towards to the voters in this election
Instructions will be provided to guide you.

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@Trinbarj_Elect

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 Name Of Candidate:
First Name: Last Name:
Click or tap here to enter text. Click or tap here to enter text.

(Insert first name here in block letters) (Insert last name here in block letters)

Middle Name:
Click or tap here to enter text.

(Insert middle name here in block letters)

Title: Sex:
Choose an item. Male

Female
(Click the dropdown arrow and select

your title) Party:

Date of Birth: Click or tap here to enter text.

Click or tap to enter a date. (Insert name of party you are representing)

(You must be 18 yrs. or older to

participate in these elections) Constituency:

Click or tap here to enter text.

(State which constituency you are in)

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For more Information:
@Trinbarj_Elect

@ Trinbarjam Elections
 Personal and Background Info:
Address:
Street Address: City:
Click or tap here to enter text. Click or tap here to enter text.

(Insert street address, Lot# and Street name) (Insert name of city)

Proof of Citizenship:

(Insert image of a valid ID card or passport)

Background Information: Page | 3

For more Information:
@Trinbarj_Elect

@ Trinbarjam Elections
Qualifications:
Secondary School Attended: University / College Attended:
Click or tap here to enter text. Click or tap here to enter text.

(State which secondary school you attended) (State which university/ college you attended)

Degrees Obtained:
Associate’s …………….. Click or tap here to enter text.
Bachelor’s …………….. Click or tap here to enter text.
Master’s ……………….. Click or tap here to enter text.
Doctorate ……………….. Click or tap here to enter text.

PhD ………..…………….. Click or tap here to enter text.

(Select what degree you have and what you have those obtained degrees in.)

Occupation:
Name of Current /Past Occupation: Place Of Work:
Click or tap here to enter text. Click or tap here to enter text.
(State name of Occupation) (State Address of place of work)

Work Experience: Name Of Organization:

Click or tap here to enter text. Click or tap here to enter text.
( State how many years you have (State the name of the organization you work at)

worked there)

Other Information:
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For more Information:
@Trinbarj_Elect

@ Trinbarjam Elections
 (Insert a Passport Sized Picture of Yourself)

Small Message to the Voters:

Click or tap here to enter text.

(In the box above, state your goals and what you wish to if you win the elections. Why should you be
elected?)

Contact Information:
Valid email address: Telephone Number:
Click or tap here to enter text. Click or tap here to enter text.

Declaration:
This is to ensure that the information provided by you is truthful to you and to us
at Trinbarjam Elections Commission. If you provide us with false information the
response to this form will be terminated.
Yes, the information provided is truthful.

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For more Information:
@Trinbarj_Elect

@ Trinbarjam Elections
At Trinbarjam Elections Commission
Wish You
GOOD LUCK!!!

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For more Information:
@Trinbarj_Elect

@ Trinbarjam Elections