NOMINATION FORM
TO: The Secretary, The Old Harrisonian Society


We hereby nominate ....................................................to serve as ................................................................... [Please state Office/Post]
of The Old Harrisonian Society for the year 2011 – 2012.

PROPOSER	SECONDER
……………………………………………… NAME (PLEASE PRINT)	……………………………………………… NAME (PLEASE PRINT)
……………………………………………… SIGNATURE	……………………………………………… SIGNATURE

………………………………………………
SIGNATURE OF NOMINEE