AMNESTY STUDENT REPRESENTATIVE Nomination Form Fill out this form and present your nomination to your Amnesty school group. Your group may elect 2 students to join the Schools Leadership Team, at least 1 must be Year 11 or below. Contact us to have an Amnesty member help with or attend your elections. If you do not have a school group, you may nominate as an individual and send your form directly to us. Name: Email: School: Year: Does your school have an Amnesty group?

Y/N

Teacher sponsor:

Please nominate a teacher that supports your nomination.

1. Why do you think you would make a good Amnesty Student Representative and member of the Schools Leadership Team?

2. If you do not have a current school group, how could you start one?

Students elected by their groups or individual nominations must email this form to [email protected]