TNAI Nomination Form for the Election for the Offices of President, Vice President for the candidates
to be nominated from the place where the TNAI Headquarters Office is located, (Delhi) Vice
Presidents, for the 2 candidates to be nominated from the States and Union Territory branches
other than Delhi. Hon. Treasurer, for the candidates to be nominated from the place where the
TNAI Headquarters Office is located (Delhi). Hon. Secretary M&ANM Association and Hon. Secretary,
Health Visitors’ League TNAI.
Please read carefully:
Full name, address and TNAI Number of the Nominator must be given
Full name and address of the nominee must be written in block letters.
The election shall be carried out by secret Ballot at the meeting of House of Delegates during
TNAI Conference at Kerala, November 2010.
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Present Office Holder
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Name of the Nominee & TNAI Number
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Designation & Address of the Nominee
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President
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*Mr. A. B. Kulkarni, JN-4/16/02 ,
“Blue Haven”, Sector-10, Vashi,
Navi Mumbai – 400703.
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First Vice Presidents
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Sr. (Prof.) GilbertPrincipal, San Joe College
of Nursing, Pulluvazhy P.O., Ernakulam Distt.
Kerala-683541.
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Second (Local) Delhi
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Dr. (Mrs.) M. Dean,
E-140, East of Kailash, New Delhi-110019.
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Third
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* Mrs. Rose Thomas, F/83, LIG Colony,
Indore-452011, Madhya Pradesh.
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Hony. Treasurer
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Mrs. S.K. Pillai, (Resigned on Feb 8, 2010)
2, Vidhi Appartments,I.P. Extn.,
Delhi-110092.
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Hony. Secretary,HVL
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Mrs. Kamlesh Tiwari#5 Basant Vihar,
Near Sanjay Atta Chakki, Ambala City, Haryana
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Hony. Secretary, M & ANMA
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Mrs. Harshali V. Shegaonkar,Gore Apt. No. 1, Behind All India Radio StationShastri Nagar,
Akola-444001, Maharashtra.
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* Not eligible for nomination
Name of Nominator_______________________________________________________________________
TNAI number of Nominator____________________________
Signature of Nominator___________________________________
Address._______________________________________________
Note : The date has been extended to 30 June, 2010 for receipt of nominations at TNAI HQ.
Please return completed form to :
Mrs OK Kathuria, Returning Officer, TNAI Elections: 2010
L-17, Florence Nightingale Lane, Green Park, New Delhi-110016
Please mark the envelop “TNAI Elections: 2010, Nomination Form” in the sealed envelope.
