E76655599DB14D28AB3C1B001BD4401C Nomination Form for Position on the Committee of Management To be elected at the CICADA AGM – 24 August 2025 Note: Nominee, Proposer, and Seconder must be members of CICADA Australia Inc. Eligibility for Nomination to the CICADA Committee To be eligible for nomination to the CICADA Australia Inc. Committee of Management, you must meet all of the following criteria: You are a current member of CICADA Australia Inc. You are over the age of 18 years. You reside in New South Wales. You are not an employee, business partner, or member of any company or organisation that may present a conflict of interest or affect your ability to serve as an elected committee member or office bearer. You do not currently hold a committee position in any other organisation, either in New South Wales or nationally, that has similar aims and objectives to CICADA. You are not aware of any legal reason that would prevent you from holding a position on the Committee of Management if elected. Date Full Name (Nominee) Full Address (Nominee) Email Address (Nominee) Committee Position -- Select -- President Secretary Treasurer General Committee Member Proposed By (CICADA Member) Proposer's Email (associated with their CICADA Membership) Seconded By (CICADA Member) Seconder's Email (associated with their CICADA Membership) By submitting this nomination form, the nominee confirms they have accepted the nomination, agree to comply with the terms and conditions associated with being a CICADA Committee member, and, if elected, meet all eligibility requirements. Submit