APPLICATION

                          2012 President and Vice President Candidate Team





Presidential Candidate (Name and UCO):         ______________________________________



Vice Presidential Candidate (Name and UCO): ______________________________________




As per Title IV of the MIMSA Constitution, three weeks of campaigning begins November 7th, 2011.
The election for 2012 President and Vice President will occur on Monday, November 28th from
10:00‐19:00.

Any questions with regards to the electoral process can be directed to the Election Committee at
mimsa‐info@mimsa.cz. Please note “ELECTION COMMITTEE:” in subject line.


By signing below, candidates certify that they have read and understand the requirements for
candidacy, especially noting that candidates may not be at risk of expulsion from the Faculty of
Medicine at Masaryk University for the duration of their 1‐year term starting December 2012.




_____________________________________
______________________________________

Presidential Candidate                                                    Date



_____________________________________
______________________________________

Vice Presidential Candidate                                           Date








Application Received by: _______________________________     _________________________

                                                  Name
 Date