New South Wales Repealed Regulations

This legislation has been repealed.

PHYSIOTHERAPISTS REGULATION 2002 - SCHEDULE 1

SCHEDULE 1 – Forms

(Clause 3 (2))

Form 1 - Nomination for elected physiotherapist

(Clause 11)

Nomination for elected physiotherapist

( Physiotherapists Act 2001 )

To the Returning Officer,

We, being registered physiotherapists, hereby nominate
*

[full name]

of

[residential address]

as a candidate at the election of elected members referred to in section 88 (1) of the Physiotherapists Act 2001

I,of

consent to the nomination and do solemnly and sincerely declare that I am a registered physiotherapist.

I make this solemn declaration conscientiously believing the same to be true, and by virtue of the provisions of the Oaths Act 1900 .

Declared atthis day of20, before me:

* The person nominated must be a registered physiotherapist.

Form 2 - Statutory declaration in support of candidature for election to the Board

(Clause 12)

Statutory declaration in support of candidature for election to the Board

( Physiotherapists Act 2001 )

I,of

1. My year of graduation as a physiotherapist was

2. I hold the following qualifications:


[academic and professional qualifications]

3. The information relevant to my candidature is:






[information relevant to candidature--not more than 6 lines]

I make this solemn declaration conscientiously believing the same to be true, and by virtue of the provisions of the Oaths Act 1900 .

Declared atthis day of20, before me:

Form 3 - Certificate of Registrar of the Physiotherapists Registration Board

(Clause 14)

Certificate of Registrar of the Physiotherapists Registration Board

( Physiotherapists Act 2001 )

I,Registrar of the Physiotherapists Registration Board, certify that the attached roll containingpages commencing with the nameand ending with the nameis a true and correct roll of persons registered as physiotherapists under the Physiotherapists Act 2001 as aton theday of20

[Registrar]

[date]

Form 4 - Ballot-paper

(Clause 15)

Ballot-paper

( Physiotherapists Act 2001 )

Ballot-paper

Election of members of the Physiotherapists Registration Board

READ CAREFULLY THE FOLLOWING INSTRUCTIONS BEFORE VOTING

1. You must vote for at least 3 candidates in the order of your preference by placing the number "1", "2" or "3" in the squares opposite the names of those candidates. You may, if you so desire, indicate your preference for the remaining candidates using the numbers "4", "5" and so on.

2. After marking your ballot-paper, fold it so that the vote cannot be seen, then place it in the Reply envelope and fasten this envelope. PRINT YOUR NAME AND ADDRESS AND SIGN YOUR NAME IN THE SPACE PROVIDED ON THE BACK FLAP OF THE ENVELOPE. Post or deliver the Reply envelope so that it will be received by the Returning Officer NOT LATER THAN[indicate date and time of close of ballot].

3. Your vote will not be accepted unless your particulars and signature are shown on the back flap of the Reply envelope. Remember to show the registered address to which voting materials were posted.

4. Only one ballot-paper is to be enclosed in each Reply envelope, otherwise the ballot-papers will not be accepted.

5. Any correspondence concerning this election should be addressed to the Electoral Commissioner for New South Wales.