NOMINATING PETITION FOR NOVEMBER SCHOOL ELECTION

Similar documents
NOMINATING PETITION FOR NOVEMBER SCHOOL ELECTION

PRIMARY ELECTION PETITION NOMINATING CANDIDATES FOR MUNICIPAL OFFICE. Clerk of the Municipality of

CANDIDATE(S) CANDIDATE S REQUEST FOR SLOGAN (OPTIONAL) (PLEASE GIVE TWO (2) CHOICES IN ORDER OF PERFERENCE) NAME RESIDENCE TELEPHONE NO.

TX Notarial Certificates

STATE OF NEW JERSEY. ASSEMBLY, No th LEGISLATURE

Form 43 AFFIDAVIT OF EXECUTION. Land Titles Act, S.N.B. 1981, c. L-1.1, s.55

Office of Health Facility Licensure & Certification

Office of Health Facility Licensure & Certification

Durable Health Care Power of Attorney and Appointment of Health Care Agent and Proxy

Instructions for Filing the Raffle Report of Operations for Non-Draw Raffles (Carnival Games and Wheels)

MURRAY XII TRUST APPLICATION SELF-SUPPORTING**

Proposals must be received in the Office of the City Manager no later than 2:00 p.m. on March 21, 2018.

DEFENSE CONSULTING SERVICES, LLC DCS Operations Center IH 10 W San Antonio TX 78249

CITY OF NAPERVILLE TRANSPORTATION, ENGINEERING, AND DEVELOPMENT BUSINESS GROUP APPLICATION FOR ENGINEERING APPROVAL

Agency of Record for Marketing and Advertising

Substitute Application Instructions

MAGNOLIA BOARD OF EDUCATION 131 Elm Ave Woodlynne, New Jersey 08107

Department of Defense DIRECTIVE

RAFFLE APPLICATION PACKET

State of New Jersey NJLRC. New Jersey Law Revision Commission FINAL REPORT. relating to OATHS AND AFFIDAVITS. March, 1999

Name: Last (Surname) First (Given) Middle Initial. Country of Birth: Country of Citizenship:

SCHEDULE D-3 Affidavit of Prime Contractor Task Order Services Contracts MBE/WBE Compliance Plan

ADDENDUM No. 1 REQUEST FOR PROPOSALS: AGENCY OF RECORD FOR MARKETING & ADVERTISING. DATE: September 3, 2015

Quakertown Fire Company, Pittstown, NJ. Franklin Township Fire District No. 1 of Hunterdon County

APPLICATION FOR REINSTATEMENT OF AN EDUCATOR S LICENSE (PRINT OR TYPE ALL INFORMATION)

NOTICE OF PRE-QUALIFICATION OF CONTRACTORS FOR THE INSTALLATION, REPLACEMENT AND/OR RELOCATION OF STORMWATER CULVERTS, PIPES AND APPURTENANCES

Connecticut: Advance Directive

REYNOLDS CHARITABLE TRUST INDIVIDUAL GRANT REQUEST FORM

INFORMATION CONCERNING THE MEDICAL POWER OF ATTORNEY

RENEWAL APPLICATION FOR A PERMIT TO ACT AS AN AGENT FOR A PRIVATE BUSINESS OR TRADE SCHOOL IN DELAWARE. Year:

SPEECH-LANGUAGE PATHOLOGY ASSISTANT (SLPA) REQUIREMENTS AND INSTRUCTIONS

Travis County Commissioners Court APPLICATION PACKET. For

Instructions Please Follow Carefully! Affidavit & Release Form and Certification of Identification Form

SCHEDULE D-1 Compliance Plan Regarding MBE/WBE Utilization Affidavit of Prime Contractor

An Advance Directive For North Carolina

U. S. ARMY QUALIFIED LAW ENFORCEMENT OFFICERS SAFETY ACT APPLICATION PART 1 LAW ENFORCEMENT OFFICERS SAFETY ACT APPLICATION NOTICE

MISSISSIPPI DEPARTMENT OF PUBLIC SAFETY SECURITY GUARD PERMIT APPLICATION

STATE OF KANSAS OFFICE OF THE ATTORNEY GENERAL Through the KANSAS BUREAU OF INVESTIGATION INSTRUCTIONS

Request for Proposal for Digitizing Document Services and Document Management Solution RFP-DOCMANAGESOLUTION1

PLEASE TYPE OR PRINT CLEARLY USING A PEN. Today s Date:

INSTRUCTIONS FOR REINSTATEMENT, REACTIVATION AND RESUMPTION OF PRACTICE APPLICATION OF A NEW JERSEY LICENSE

MERCER COUNTY SHERIFF S OFFICE CITIZEN S ACADEMY APPLICATION

Office of Health Facility Licensure & Certification

Poll Managers. Oaths and Forms For General Elections. Precinct County Date

Request for Qualifications and Proposals (RFQ/P) #564. for. Program and Construction Management Services

Chapter 9 OFFICE OF EMERGENCY MANAGEMENT

Washington County Tennessee Sheriff s Office. Ed Graybeal, Sheriff. Employment Application Packet

First District, Alameda County Pleasanton, CA BOARDS AND COMMISSIONS. Agenda: July 21, 2015

ADVANCE DIRECTIVE FOR A NATURAL DEATH ("LIVING WILL")

Date: April 6, 2018 SUBJECT: REQUEST FOR QUALIFICATIONS. RFQ # Business Analyst Services

REGULATION RESPECTING FORMS TO BE USED IN NUNATSIAVUT ELECTIONS

SOUTH CAROLINA HEALTH CARE POWER OF ATTORNEY

West Virginia Board of Osteopathic Medicine 405 Capitol Street, Suite 402 Charleston, WV Osteopathic Physician Assistant Practice Agreement

PROGRAM STATEMENT. County of Bergen

Town of Billerica Police Department 6 Good Street Billerica, Ma (978) Fax (978)

VOLUNTEER APPLICATION

NURSING HOME ADMINISTRATOR REQUIREMENTS AND INSTRUCTIONS

WARNING: LIVING WILLS AND GENERAL POWERS OF ATTORNEYS ARE VERY POWERFUL DOCUMENTS. CHOOSE YOUR AGENT VERY CAREFULLY. Sample Living Will 2

Advance Health Care Directive (CT)

PART 1 - DOCUMENTARY REVIEWS AND GENERAL BOARD REQUIREMENTS

TRICARE PROVIDER FILE APPLICATION NAME: SOCIAL SECURITY NO: If you are solo incorporate, please give EIN#:

City of Lees Summit Department of Planning and Development Type 4 Special Event Fireworks Sales Application Form

HEALTH CARE POWER OF ATTORNEY

ADVANCE DIRECTIVE FOR A NATURAL DEATH ("LIVING WILL")

FORMING AN IEEE STUDENT BRANCH

Navasota Economic Development Corporation

This package is meant to be used simply as a guide. The State Legalized Games of Chance has full authority over games of chance.

WAUCONDA FIRE DISTRICT Applicant Handbook

Request for Proposal Professional Auditing Services

VILLAGE OF SOUTH ELGIN APPLICATION FOR LIQUOR LICENSE FOR INDIVIDUALS AND NON-INCORPORATED ENTITIES

ALASKA ADVANCE HEALTH CARE DIRECTIVE for Client

Employer Approval for Alaska Limited Governmental Notary Commission

Earl C. Sams Foundation, Inc. 101 N. Shoreline Blvd, Suite 602 Corpus Christi, TX Grant Application

Professional Credential Services, Inc.

Living Will and Appointment of Health Care Representative (CT)

RESIDENCY CLASSIFICATION MILITARY ACTIVE DUTY PETITION

New Mexico Bingo, Raffle, & Pull Tab Renewal Application

REGISTERED DIETITIAN

GENERAL APPLICATION FOR EMPLOYMENT Human Resources City of New Smyrna Beach 210 Sams Avenue New Smyrna Beach, Florida 32168

CITY OF BRANDON POLICE DEPARTMENT APPLICATION FOR EMPLOYMENT. ALL applicants MUST attach items 1, 2, 3, 4 I. PERSONAL HISTORY

Retail Façade Improvement Award Program Application Packet

Name of Student Birth Date Sex Grade. Parent/Guardian Phone Number. Address: City Zip

REQUEST FOR PROPOSAL DOCUMENTS FOR RFP B CONSULTING SERVICES FOR BRANDING AND MARKETING CAMPAIGN FOR CONTINUING EDUCATION AND WORKFORCE TRAINING

CONNECTICUT Advance Directive Planning for Important Health Care Decisions

TRICARE West Region Provider Management P.O. Box 7066 Camden, SC Fax

SPEECH-LANGUAGE PATHOLOGY ASSISTANT (SLPA) REQUIREMENTS AND INSTRUCTIONS

Professional Credential Services, Inc.

DALTON PUBLIC SCHOOLS REQUEST FOR PROPOSAL. RFP FY18 Drivers Education RFP

State of Ohio Durable Power of Attorney for Health Care

INSTRUCTIONS AND REQUIREMENTS FOR REINSTATEMENT / REACTIVATION OF A SOUTH CAROLINA RN OR LPN LICENSE

STEP BY STEP INSTRUCTIONS FOR COMPLETING THE CALIFORNIA ADVANCE HEALTH CARE DIRECTIVE

NURA 1013 Medication Administration I Checklist

Name Date (First) (MI) (Last Address (Street) (City) (State) (Zip) Phone Parent s Name. Birth Date: Age School Present Grade.

1221 Oak Street, Suite 536, Oakland, California Phone: Pleasanton District Office: Fax:

YUROK TRIBE REQUEST FOR PROPOSAL & QUALIFICATIONS (RFP & RFQ)

EXPRESSION OF INTEREST IN APPOINTING A PANEL OF ATTORNEYS

Compliance with Selective Service Registration Policy Determination of Knowing and Willful Failure to Register Military Selective Service Act (MSSA)

Hillsborough County Fire Rescue Reserve Responder Program 9450 E Columbus Ave Tampa, FL Office: Fax:

Application for Certification as a Groundwater Professional National Ground Water Association

CITY OF PORT ARANSAS, TEXAS REQUEST FOR PROPOSAL (RFP) FIRE STATION TEMPORARY FACILITY NOTICE TO BIDDERS

Transcription:

NOMINATING PETITION FOR NOVEMBER SCHOOL ELECTION PETITION MUST BE FILED WITH COUNTY CLERK S OFFICE ELECTIONS DIVISION One Bergen County Plaza Room 130, Hackensack, NJ 07601 On or before 4:00 PM on the last Monday in July (July 25 th, 2016) A. QUALIFICATIONS 1 of 5 Candidates filing a nominating petition for school board membership must meet the following qualifications: 1. Citizen of the United States of America 2. At least 18 years of age to qualify for office 3. Able to read and write 4. A resident of the Municipality from which he/she is to be elected for at least one year preceding the date of the Election 5. Not disqualified as a voter pursuant to N.J.S.A. 19:4-1, 18a:12-1* 6. A registered voter in the Municipality they are running B. NOMINATING STATEMENT We, the undersigned, are eligible voters of the _ School District, of (Municipality) in Bergen County, New Jersey. We hereby endorse the following candidate(s) : Name(s) of Candidate(s) Residence Address City Zip Code Phone # as a candidate(s) for membership on the Board of Education, representing: _ (Name of Municipality/Regional School) For the (Full or Unexpired) term of (No. of Years) years and we hereby request that the name of said candidate(s) be printed on the official ballot to be used at the ensuing Election for the Board of Education to be held on November, 20.

2 of 5 At the request of one or more candidates, the ballot for a school election may include a designation in not more than three words that conveys the principles which the candidate or candidates therein named represent, but such designation shall not contain the name, or a derivative or any part thereof, as a noun or an adjective of any political party entitled to participate in a primary election. SLOGAN _ (NOTE: Slogan must not exceed three words and must be in accordance with N.J.S.A. 19:13-4) C. SIGNATORIES At least Ten (10) signatures are required to nominate a candidate, one of which may be the candidate s. We, the undersigned petitioners, hereby certify that we are eligible voters, and that the said candidate (Name of Candidate) is legally qualified under the law of the State to be elected as a member of the Board of Education. 1) 2) 3) 4) 5)

3 of 5 6) 7) 8) 9) 10) 11) 12) 13) 14) 15) 16)

D. AFFIDAVIT OF PERSON WHO CIRCULATES THIS PETITION AND WITNESSES SIGNATURES 4 of 5 The witness taking the affidavit below must be the person who obtained the signatures on this petition. The circulator must take the affidavit for a petition he/she solicits and sign in the presence of a person authorized to administer affidavits (e.g. notary public). State of New Jersey } S.S. County of Bergen }, circulator of this nominating petition, being (Print name of Circulator/Witness) duly sworn or affirmed according to the law on oath, deposes and says: The above petition is signed by each of the signers thereof in his/her own handwriting the signers are, to my best knowledge and belief, legally qualified to vote at the school district election for which the candidate is nominated, and that the petition is prepared and filed in absolute good faith for the sole purpose of endorsing the candidate and placing the candidate s name on the official ballot in order to secure election as a member of the Board of Education. The circulator further affirms that he/she is eligible to vote in the state of New Jersey, and meets the age, citizenship and inresidency requirements as required by New Jersey law (N.J.S.A. 19:13-7). Subscribed and sworn before me at:, N.J., This day of, 20. of Circulator/Witness Street Address of Circulator/Witness City or Town, Zip Code of Notary or Attorney at Law of New Jersey of Notary or Attorney at Law of New Jersey Commission Expiration Date of Notary NOTICE: All candidates are required by law to comply with the provisions of the New Jersey Campaign Contributions and Expenditures Reporting Act (N.J.S.A. 19:44 A-1 TO 44). For further information, please call ELEC at 1(609)292-8700.

5 of 5 E. CANDIDATE S ACCEPTANCE / OATH OF ALLEGIANCE State of New Jersey } S.S. County of Bergen }, candidate for membership on the Board of Education named in the foregoing petition, does hereby certify that, if elected, he/she is qualified to be elected a member of the Board of Education; that he/she consents to accept and qualify as a member of the said body. He/she further affirms and declares he/she is not disqualified pursuant to N.J.S.A. 19:4-1. I further do solemnly swear (or affirm) that I will support the Constitution of the United States and the Constitution of the State of New Jersey; that I will bear true faith and allegiance to the same and to the Governments established in the United States and in this State, under the authority of the people. So help me God. Subscribed and sworn before me at:, N.J., of Candidate This day of, 20. of Notary or Attorney at Law of New Jersey of Notary or Attorney at Law of New Jersey Commission Expiration Date of Notary