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 (1) The term "registered mental nurse includes a registered nurse for the mentally subnormal.

(2) Here insert full name, including Christian names, of candidate.

(3) Here insert candidate's address. (4) Here insert candidate's registration number.

N.B.—A nurse may not nominate more than two candidates.

(Form of declaration to be issued with the nomination paper for return by the candidate nominated)

(Date)

I consent to be nominated as a candidate for election as a representative of registered mental nurses (1) to serve on the Mental Nurses Committee of the General Nursing Council for England and Wales. I declare that the statement in the nomination paper with regard to my qualification is correct.

Name in full (in BLOCK LETTERS)

Address

Registration Number

(1) The term "registered mental nurse" includes a registered nurse for the mentally subnormal.

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