FORM B :

NOMINATION FORM FOR MEMBERSHIP OF THE COMMITTEE FOR SPATIAL INFORMATION

I,                                                                                   in my capacity as                                                                      hereby nominate for the purposes of section               of the Spatial Data Infrastructure Act, 2003, to be considered for appointment to the Committee for Spatial Information.

I,                                                                                           (name), hereby declare that I am not disqualified in terms of section 8 of the Spatial Data Infrastructure Act, 2003, to serve on the Committee for Spatial Information and I authorise the Minister of Rural Development and Land Reform to investigate any record in relation to a possible disqualification or requirement.

Qualifications:

Membership to professional bodies: (e.g. SACG)

Skills:

Experience:

I,                                                                                 , hereby accept the nomination and further certify that the provided information is correct.

Nominations must be sent to: The Director-General, Department of Rural Development and Land Reform, Private Bag X833, Pretoria, 0001, email address: [email protected].