FORM FOR NOMINATION FOR THE BOARD OF THE AFRICAN THINK TANK

I_______________________________________________________________(print name)

hereby nominate__________________________________________________(print name) as a Board member of the African Think Tank.

Signature of Nominator:______________________________________________________

Date: ____/____/_____

I_______________________________________________________________(print name)

accept nomination to the Board of the African Think Tank.

Signature of Nominee:________________________________________________

Date: ____/____/_____

Are you a member of an African Community? Yes_____ No______ (please tick).

If yes, please state which community:____________________________________________

I ________________________________________________________________(print name)

second ___________________________________________________________(print name) as a Board member of the African Think Tank.

Date: ____/____/_____

Signature of Seconder:______________________________________________________

Send to: African Think Tank

P.O.BOX 2307, Footscray
Melbourne, Australia, 3011