Details of the Nominator

Name and Surname

ID NO.

District

Ward No.

Municipality

Details of the Nominee

Name and Surname

ID No.

District.

Category.

I nominate the person above for the position

2. Brief Reason why I nominate the candidate

3. Acceptance Of the Nomination

Identity Document
Professional Registration
Proof of admission to the practice
I accept the nomination of the above-mentioned Mental Health Review board, and i shall endevour to promote good governance and development of the district and promote the mendate of the Mental Health Review Board for the benefit of the community within the area of jurisdiction

NOTE: Please make sure nominee CV and Qualifications is uploaded

Add Qualification

(Attatchment must not exceed 4MB, in case it exceed please 4mb please upload it one by one)

Attatchment Owner Action

Add Carriculum Vitea

(Attatchment must not exceed 4MB, in case it exceed please 4mb please upload it one by one)

Attatchment Owner Action