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Council Nomination Form (Nominee)

Step 1 of 3

Part 1: Nomination

I am offering myself as a nominee for the following position(Required)
If you do not know your CRNNL Registration Number, please use the Member Search to find it.

Contact Information

By providing your e-mail address, you will receive a confirmation message when the form is submitted.

Present Position

Please identify your employer, position, area of practice and employment dates for your current employment.


Please provide the following information about the member who has agreed to be your nominator.

Declaration - Part I

By submitting this form, I declare the following to be true(Required)
If elected, I agree to(Required)