Candidature form

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MISA ZAMBIA 2008 AGM CANDIDATURE FORM

NAME: ____________________________________________________________________________ ___ AGE: ____________________________________________________________________________ ___ POSITION ASPIRED FOR : ____________________________________________________________________________ ___ WHEN DID YOU BECOME FULLY PAID UP MEMBER OF MISA ZAMBIA? ____________________________ NAME OF ORGANISATION YOU WORK FOR: ____________________________________________________________________________ ________

POSITION HELD : ____________________________________________________________________________ _________ PREVIOUS POSITION HELD:_______________________________________________________________________ ________ BRIEF BACKGROUND ABOUT YOURSELF:__________________________________________________________________ _________


EDUCATIONAL QUALIFICATIONS: ____________________________________________________________________________ _________

EXPERIENCE IN THE MEDIA: ____________________________________________________________________________ _________ ORGANISATIONAL/ LEADERSHIP ABILITIES:

WHAT WILL YOU DO FOR MISA ZAMBIA?

SIGNATURE : ____________________________________________

DATE : __________________________________________________


NB: ADDITIONAL INFORMATION SHOULD BE WRITTEN ON A SEPARATE PIECE OF PAPER.

The forms may be hand delivered to the MISA Secretariat on Plot number 3814, Martin Mwamba RD. Olympia Park, Lusaka or faxed to 292096, 294285, 294286


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