I, Dr. (nominee), and am a life member of ISNSC with membership no. , hereby give consent to contest for the post in ISNSC.

I declare that:

1. I am an active member in good standing and my membership subscription / dues are up to date.
2. The information provided in this form is true and correct to the best of my knowledge.
3. I agree to abide by the rules, bylaws, and election process of ISNSC.