Christian Electors of the Election Committee Candidate Application Form For Official Use Only (Nomination by Individuals) Part I. Nomination A. Candidate Information: Name: (Chinese) (English) Date of Birth: (yyyy) (mm) (dd) Sex: HKID No.: Address: (Home) Tel: (Mobile) (Office) (Home) Fax: E-mail address: Church Affiliation: B. Certified by Affiliated Church: This is to certify that the above candidate is a member of our church, through baptism or soldier enrollment. Name of Church: Stamp of Church: Name of Pastor/Responsible Person: Signature of Pastor/Responsible Person: Date:
C. Information of Twenty Nominators: This Candidate Nomination Form must be completed and signed by at least twenty persons aged 18 or who are above baptized Christians or church members. Nominators must provide proof of Christian status. Part II. The candidate must agree to be nominated, to declare his/her qualification, and to authorize the release of his/her personal information (to be completed by the Candidate). 1. I, the nominee as stated in Part I for this form, declare that I accept the nomination to be a candidate for the Representatives of Christian (Protestant) Sub-sector for the Election Committee and agree that Hong Kong Christian Council shall have the final decision on all matters related to the selection. 2. I hereby confirm that all information related to myself in Part I of this form is true and correct. 3. I hereby declare that I have the qualifications to be nominated as a candidate for the Representatives of Christian (Protestant) Sub-sector for the Election Committee. I have registered as an elector (voter) of Hong Kong and have been baptized or am a member of a church. Signature of Nominee: Date: The applicant must submit the application form in person to the secretariat of Christian Electors to the Election Committee at 9/F, Christian Ecumenical Building, 33 Granville Road, Tsimshatsui, Kowloon. It is recommended that the applicant make an appointment online as we will process the application via e-booking first. For online book please visit https://goo.gl/lmtdts or scan
Information of Twenty Nominators Name of Nominee: 1. Name of Nominator: Signature: A. Certificate of baptism 2. Certificate of church membership 3. Certificate of Christian identity * 2. Name of Nominator: Signature: 3. Name of Nominator: Signature: 4. Name of Nominator: Signature: 5. Name of Nominator: Signature: 6. Name of Nominator: Signature: 7 Name of Nominator: Signature: 8 Name of Nominator: Signature:
Name of Nominee: 9 Name of Nominator: Signature: 10 Name of Nominator: Signature: 11 Name of Nominator: Signature: 12 Name of Nominator: Signature: 13 Name of Nominator: Signature: 14 Name of Nominator: Signature: 15 Name of Nominator: Signature: 16 Name of Nominator: Signature: 17 Name of Nominator: Signature:
18 Name of Nominator: Signature: 19 Name of Nominator: Signature: 20 Name of Nominator: Signature: * Please submit a copy of the nominator s Certificate of baptism or Church membership certificate. Alternatively, he or she may submit a Certificate of Christian identity which can be downloaded from the website of the Hong Kong Christian Council. All personal data collected will be used for this activity only. The data will be destroyed after the Christian Electors are selected.