Presidential Election Nomination Paper

2016

IMPORTANT INFORMATION All candidacies for the office of president of the Ordre des ingénieurs du Québec must be supported by the signatures of at least 30 OIQ members (Part 2). To be eligible, candidates must have their personal domicile in Québec and be registered on the OIQ roll by 4:00 p.m. on MARCH 29, 2016. Finally, a member cannot be a candidate for both the office of president and a directorship. The completed nomination paper and the following accompanying documents (below on the left) must be received by the: SECRETARY OF THE OIQ AND DIRECTOR OF LEGAL AFFAIRS 1100 avenue des Canadiens-de-Montréal, suite 350 Montreal, Quebec H3B 2S2 or e-mail address: [email protected] by no later than 4 p.m. on March 29, 2016

– A recent photograph (JPEG format) – Statement by the candidate (maximum of 400 words) – A short curriculum vitae – Sworn declaration (Part 3) Part 1 – Candidate information I, the undersigned,

First name

member number:

,

Last name

, am submitting my candidacy for the office of president of the OIQ.

Address of the candidate's domicile: City: Telephone (work):

Province:

Postal code: Cell:

E-mail (work): I hereby declare that: I am a member of the Ordre des ingénieurs du Québec. My domicile is in the electoral region where I am running as a candidate. My right to engage in professional activities is neither restricted nor suspended.

Signature

Date

In this document, the masculine is used without discrimination and solely to lighten the text.

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Part 2 – Support I confirm that I am a member of the Ordre des ingénieurs du Québec and I support the candidacy of ____________________________________for the office of president of the Ordre des ingénieurs du Québec. FIRST AND LAST NAME (print)

MEMBER NO.

DATE

SIGNATURE

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 This page can be reproduced

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Part 2 – Support (continued) FIRST AND LAST NAME (print) 31

MEMBER NO.

DATE

SIGNATURE

32 33 34 35 36 37 38 39 40

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Part 3 – Candidate’s declaration

I, the undersigned, under member number

, practicing engineer duly registered on the OIQ roll , solemnly declare that:

 I agree to fulfill the duties that will be entrusted to me as part of my office as president, particularly the duty to act with diligence and loyalty, in the interest of the OIQ and its mission;

 I have read the Code of Ethics and Professional Conduct of Directors applicable to members of the Board of Directors, and I agree to comply with it if I am elected;

 I acknowledge having read, and agree to comply with, the legislation and regulations governing the holding of the 2016 elections of the Ordre des ingénieurs du Québec, including: • •

the Règlement sur la représentation et les élections au Conseil d’administration de l’Ordre des ingénieurs du Québec (French only); the Directives relatives à la conduite de la campagne électorale pour les élections 2016 (French only).

I acknowledge that I have not been nor am I the subject of proceedings (civil, regulatory, penal, criminal or disciplinary).

 Yes, I acknowledge this.  No. In this case, please explain the nature of the proceedings in a separate document. IN WITHNESS WHEREOF, I have signed in ___________________ this ____________ day of the month of ____________ in the year

.

Signature

Solemnly declared before me in ________________________________ this ___________________________

________________________________________ Commissioner of Oaths for all judicial districts in Québec Page 4 of 4