Dear Presidents / Secretaries (2012-2013)
Greetings .
Application are invited for the post of “ District
Interact Representative (DIR)“ for
the year 2013-14. Applications with all
details of the candidate should reach DG by 31.12.12 by 5pm.
Elections will be held on 6th january
2013 at the Interact Conference at Hubli.
Proposal should be submitted on club letter
head.
Rtn. Dr. Jorson Fernandes.
DG
12-13
Candidates
Details
Name of the Candidate nominated for DIR :
………………………………………………………………………………………………
Member of Interact
Club : ……………………………………………………………………………………………………………………….
Name of the School :
……………………………………………………………………………………………………………………………………
Name of Sponsoring Rotary Club :
……………………………..………………………….…………………………………………………….
Correspondence Address :
…………………………………………………………………………………….…………………………………….
……………………………………………………………………………………………….…………………………………………………………………….
Tel. ( R) with Std code
………………………….…………………………… Mobile: ……………….………………………………………… Email Id :.
…………………………………………………………………………………………………………………………………………………..
Date of Birth :……………………………………………………….
Date :………………………….. Signature
of Candidate
Place :
…………………………
Nomination for
sponsoring DIR ( 2013-14) was approved in monthly / extraordinary BOD
meet held on …………………………………
Proposal should be submitted on club letter head.
Signature :____________________________________________
Name :____________________________________________
Designation President / Secretary
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