Convocation Nomination Form

NOMINATION FORM: PRESIDENT OF CONVOCATION Nomination by eligible Members of the Cape Peninsula University of Technology (CPUT) Convocation for the election of a President of the Convocation DETAILS OF NOMINEE SURNAME:

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STUDENT NUMBER: ______________________ ID NUMBER: ________________________________ COMPANY/ORGANISATION: ___________________________________________________________ CONTACT DETAILS: Email address

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Address

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Cell Number

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DETAILS OF NOMINATOR SURNAME:

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STUDENT NUMBER: ______________________ ID NUMBER: ________________________________ COMPANY/ORGANISATION: ___________________________________________________________ CONTACT DETAILS: Email address

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Address

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Cell Number

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Declaration by the Nominator: As Nominator and by signing this form, I declare the following: • I am a member of the Convocation as contemplated in Clause 69 (1) read with 69 (2) of the CPUT Statute.

• I have read and understand the eligibility criteria for nomination and election of President of the Convocation as per Clause 12 of the CPUT Convocation Constitution.

• I acknowledge that all information, including personal information of the Nominee, provided is correct and that I have the necessary permission and consent from the Nominee to provide CPUT with the aforesaid information.

• I acknowledge that all my information provided is correct and give permission that my personal information may be processed by CPUT, Operator and relevant employees for the purpose of nomination and election of a President of the Convocation and processes related thereto.

Signature of Nominator:

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Date: _________________________

Motivation Statement by Nominator supporting the nomination: (May be attached as a separate document):

Seconders: Declaration by Seconders: As Seconder, and by signing this form, I declare the following: • • •

I am a member of the Convocation as contemplated in Clause 69 (1) read with 69 (2) of the CPUT Statute.

I have read and understand the eligibility criteria for nomination and election of President of the Convocation as per Clause 12 of the CPUT Convocation Constitution.

I acknowledge that all my information provided is correct and give permission that my personal information may be processed by CPUT, Operator and relevant employees for the purpose of nomination and election of a President of the Convocation and processes related thereto.

Details of Seconders (Please provide full first names and surname): ► Seconder 1: ..........................................................................................................................................................................

Signature: ....................................ID no: .................................................Student no: ………………………….

Cell: ................................... Tel: .......................................... Email: ................................................................ ► Seconder 2: ..........................................................................................................................................................................

Signature: ....................................ID no: .................................................Student no: ………………………….

Cell: ................................... Tel: .......................................... Email: ................................................................ ► Seconder 3: ..........................................................................................................................................................................

Signature: ....................................ID no: .................................................Student no: ………………………….

Cell: ................................... Tel: .......................................... Email: ................................................................ ► Seconder 4: ..........................................................................................................................................................................

Signature: ....................................ID no: .................................................Student no: ………………………….

Cell: ................................... Tel: .......................................... Email: ................................................................ ► Seconder 5: ..........................................................................................................................................................................

Signature: ....................................ID no: .................................................Student no: ………………………….

Cell: ................................... Tel: .......................................... Email: ................................................................

ACCEPTANCE AND UNDERTAKING BY NOMINEE I, the undersigned confirm that I am eligible to be nominated as the President of the Convocation. I hereby, accept the nomination and confirm my willingness to serve and fulfill the duties as President of the Convocation should I be elected to that position. I have read and understand the information contained in the CPUT Convocation Constitution, particularly Clauses 11 and 12 thereof.

Full Name(s) & Surname:

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ID Number:

________________________________Student Number: _______________

Date and Place:

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Signature:

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Short biography of the nominee – (indicating qualification/s, date/s obtained, level of knowledge, skills, and achievements) (May be attached as a separate document)

Declaration by the Nominee: 1. I acknowledge that all the information provided is correct.

2. I authorise and consent to the submission of the information, including my personal information to CPUT, Operator and relevant employees to collate, collect, process, store, use and disclosure of such information for the purpose of nomination of a President of the Convocation and processes related thereto.

3. I am a member of the CPUT Convocation as contemplated in clause 69 (1) read with 69 (2) of the CPUT Statute, and eligible for election to the office of the President.

4. I have obtained my first qualification at the CPUT/PENTECH or CAPE TECH at least ten (10) years before the nomination date.

5. I am not an employee nor a current student at the University.

6. I have not been a student for a continuous period of at least 5 (five) years from date of nomination.

7. I have been a member of the Convocation for at least 10 (ten) years. ___________________________ Signature of Nominee Date: _______________________

Please submit duly completed nomination forms, CVs, and written motivations supporting the nomination to: ConvoElect@cput.ac.za on or before Wednesday, 20 August 2025.