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IFAC Candidate Information Form

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<strong>IFAC</strong> <strong>Candidate</strong> <strong>Information</strong> <strong>Form</strong> 1<br />

The candidate would be willing to accept a technical advisor from another<br />

nominating organization<br />

Nominating Contact <strong>Information</strong><br />

Contact Last Name<br />

Contact First Name<br />

Contact Title<br />

Address Line 1<br />

Address Line 2<br />

Contact State/Province<br />

Contact Postal Code<br />

Contact Telephone<br />

Contact Fax<br />

Contact Email<br />

Is this a joint nomination?<br />

Is the candidate being considered for multiple nominations?<br />

Is the candidate being renominated?<br />

What type of support will the nominating organization provide?<br />

The nominating organization will support the candidate in case of<br />

appointment. This support includes that no undue influence, financial or<br />

otherwise, will be exerted that might impair the member’s ability to act with<br />

independence, integrity and in the public interest<br />

Please note that if the candidate is appointed, the information in this form will be used to compile a short<br />

biography for publication on the <strong>IFAC</strong> website. The candidate will have an opportunity to review his or her<br />

biography before it is published.

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