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<body lang=EN-ZA link=blue vlink=purple>
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<div align=center>
<table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=707
style='border-collapse:collapse'>
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height:114.0pt'>
<p class=MsoNormal><b><span lang=EN-GB style='font-size:12.0pt;font-family:
"Arial","sans-serif"'><o:p> </o:p></span></b></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>TO:
ALL CORPORATE MEMBERS<b><o:p></o:p></b></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoBodyText><span lang=EN-GB style='font-family:"Arial","sans-serif"'>NOMINATIONS
FOR ELECTION OF COUNCIL FOR 2011<o:p></o:p></span></p>
<p class=MsoNormal><b><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></b></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Nomination
for election to Council must be accompanied by a Curriculum Vitae of the
nominee not exceeding 75 words. According to a 2004 Council resolution, candidates
are requested to submit a focus statement. Please see Section C.<b><o:p></o:p></b></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoBodyText2><span lang=EN-GB style='font-family:"Arial","sans-serif"'>The
CV will accompany the ballot form and the format of the CV is shown below.<o:p></o:p></span></p>
<p class=MsoBodyText2><span lang=EN-GB style='font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
</tr>
<tr style='page-break-inside:avoid'>
<td width=707 valign=top style='width:529.9pt;border:double windowtext 2.5pt;
background:#DFDFDF;padding:0cm 5.4pt 0cm 5.4pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoBodyText><span lang=EN-GB style='font-family:"Arial","sans-serif"'>Section
A:<o:p></o:p></span></p>
<p class=MsoBodyText2><span lang=EN-GB style='font-family:"Arial","sans-serif"'>Information
concerning the nominee’s contribution to the Institution.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoBodyText><span lang=EN-GB style='font-family:"Arial","sans-serif"'>Section
B:<o:p></o:p></span></p>
<p class=MsoBodyText2><span lang=EN-GB style='font-family:"Arial","sans-serif"'>Information
concerning nominee’s career, with special reference to civil
engineering positions held, etc.<o:p></o:p></span></p>
<p class=MsoBodyText2><b><span lang=EN-GB style='font-family:"Arial","sans-serif"'><o:p> </o:p></span></b></p>
<p class=MsoBodyText2><b><span lang=EN-GB style='font-family:"Arial","sans-serif"'>Section
C:<o:p></o:p></span></b></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>A
brief statement of what the nominee intends to promote / achieve / stand /
introduce / contribute or preferred area of interest.<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
</tr>
<tr style='page-break-inside:avoid;height:246.5pt'>
<td width=707 valign=top style='width:529.9pt;padding:0cm 5.4pt 0cm 5.4pt;
height:246.5pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Please
Note : Nominations received <b><u>without</u></b> an attached CV will <b><u>not</u></b>
be considered.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><b><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Closing
date:</span></b><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>
<b>30</b><b> July 2010.</b> Acceptable transmission formats - email, fax and
ordinary mail. All ballots are treated with due respect of confidentiality<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>If
more than 10 nominees from Corporate Members are received a ballot will have
to be held.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>If
the ballot is to be held, the closing date for the ballot will be 31<sup>st</sup>
August 2010.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Notice
of the ballot will be sent out using two formats, i.e.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal style='margin-left:46.5pt;text-indent:-18.0pt;mso-list:
l0 level1 lfo2'><![if !supportLists]><span style='font-size:12.0pt;
font-family:"Arial","sans-serif"'><span style='mso-list:Ignore'>1<span
style='font:7.0pt "Times New Roman"'> </span></span></span><![endif]><span
style='font-size:12.0pt;font-family:"Arial","sans-serif"'>By e-mail to those
Corporate Members whose electronic address appears on the SAICE database, and<o:p></o:p></span></p>
<p class=MsoNormal style='margin-left:28.5pt'><span style='font-size:12.0pt;
font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal style='margin-left:46.5pt;text-indent:-18.0pt;mso-list:
l0 level1 lfo2'><![if !supportLists]><span style='font-size:12.0pt;
font-family:"Arial","sans-serif"'><span style='mso-list:Ignore'>2<span
style='font:7.0pt "Times New Roman"'> </span></span></span><![endif]><span
style='font-size:12.0pt;font-family:"Arial","sans-serif"'>By normal surface
mail to those members who have not informed SAICE of an e-mail address.<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
</tr>
</table>
</div>
<p class=MsoNormal><span style='font-size:7.0pt'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:7.0pt'><o:p> </o:p></span></p>
<div align=center>
<table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=697
style='border-collapse:collapse'>
<tr style='page-break-inside:avoid;height:82.0pt'>
<td width=678 valign=top style='width:508.6pt;padding:0cm 5.4pt 0cm 5.4pt;
height:82.0pt'>
<p class=MsoBodyText><span lang=EN-GB style='font-family:"Arial","sans-serif"'>THE
SOUTH AFRICAN INSTITUTION OF CIVIL ENGINEERING<o:p></o:p></span></p>
<p class=MsoBodyText><span lang=EN-GB style='font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoBodyText2><b><span lang=EN-GB style='font-family:"Arial","sans-serif"'>Nomination
for Election of Members of Council for the year 2011 in terms of Clause 3.1
of the By-Laws<o:p></o:p></span></b></p>
<p class=MsoBodyText2><b><span lang=EN-GB style='font-family:"Arial","sans-serif"'><o:p> </o:p></span></b></p>
</td>
<td style='border:none;padding:0cm 0cm 0cm 0cm' width=19><p class='MsoNormal'> </td>
</tr>
<tr style='page-break-inside:avoid;height:377.5pt'>
<td width=678 valign=top style='width:508.6pt;border:double windowtext 4.5pt;
padding:0cm 5.4pt 0cm 5.4pt;height:377.5pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>In
accordance with Clause 3.3 of the Constitution, the Council has elected
Office Bearers for the Institution for 2011 as follows:<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>President <b>Mr
SN Makhetha<o:p></o:p></b></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>President
Elect <b>Dr
M van Veelen</b><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Vice
President <b>Mr
T McKune<o:p></o:p></b></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Vice
President <b>Prof
H Gräbe<o:p></o:p></b></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Vice
President <b>Mr
S Mkhacane</b><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Vice
President <b>Mr
P Kleynhans</b><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>In
terms of Clause 3.2.4 of the Constitution, the following are ipso facto
members of the Council for the year 2011:<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<h1><span lang=EN-GB style='font-family:"Arial","sans-serif";font-weight:
normal'>The immediate Past President</span><span lang=EN-GB style='font-family:
"Arial","sans-serif"'> Mr
AM Naidu<o:p></o:p></span></h1>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>The
two most recent Past Presidents <b>Prof
EP Kearsley</b><o:p></o:p></span></p>
<p class=MsoNormal><b><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'> Mr
JJ de Koker</span></b><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Clause
3.1.1 of the By-Laws reads as follows:<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>“Every
candidate for election to the Council shall be a Corporate Member and shall
be proposed by a Corporate Member and seconded by another Corporate
Member.” Nominees accepting nomination are required to sign opposite
their names in the last column of the nomination form.<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=19 valign=top style='width:14.15pt;padding:0cm 5.4pt 0cm 5.4pt;
height:377.5pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<h1><span lang=EN-GB style='font-family:"Arial","sans-serif"'><o:p> </o:p></span></h1>
<h1><span lang=EN-GB style='font-family:"Arial","sans-serif"'><o:p> </o:p></span></h1>
<h1><span lang=EN-GB style='font-family:"Arial","sans-serif"'><o:p> </o:p></span></h1>
<p class=MsoNormal><b><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></b></p>
<p class=MsoNormal><span style='font-size:10.0pt;font-family:"Times New Roman","serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal><span style='font-size:5.0pt'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:5.0pt'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:5.0pt'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:5.0pt'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:5.0pt'><o:p> </o:p></span></p>
<p class=MsoNormal><b><span lang=EN-GB style='font-size:12.0pt;font-family:
"Arial","sans-serif"'><o:p> </o:p></span></b></p>
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</div>
<p class=MsoNormal><span lang=EN-GB style='font-size:10.0pt'><o:p> </o:p></span></p>
</div>
<span style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><br
clear=all style='page-break-before:always'>
</span>
<div class=Section2>
<div align=center>
<table class=MsoNormalTable border=1 cellspacing=0 cellpadding=0
style='border-collapse:collapse;border:none'>
<tr style='height:15.6pt'>
<td width=963 colspan=7 valign=top style='width:722.4pt;border:double windowtext 4.5pt;
border-bottom:solid windowtext 1.0pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal align=center style='text-align:center'><span lang=EN-GB
style='font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<h3 align=center style='text-align:center'><span lang=EN-GB style='font-family:
"Arial","sans-serif"'>NOMINATION FORM 2011<o:p></o:p></span></h3>
<p class=MsoNormal align=center style='text-align:center'><span lang=EN-GB
style='font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
</tr>
<tr style='height:15.6pt'>
<td width=963 colspan=7 valign=top style='width:722.4pt;border-top:none;
border-left:double windowtext 4.5pt;border-bottom:solid windowtext 1.0pt;
border-right:double windowtext 4.5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<h5><span lang=EN-GB>10 Corporate Members <o:p></o:p></span></h5>
<p class=MsoNormal align=center style='text-align:center'><span lang=EN-GB
style='font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
</tr>
<tr style='page-break-inside:avoid;height:15.6pt'>
<td width=136 rowspan=2 valign=top style='width:102.3pt;border-top:none;
border-left:double windowtext 4.5pt;border-bottom:solid windowtext 1.0pt;
border-right:solid windowtext 1.0pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<h2><span lang=EN-GB style='font-family:"Arial","sans-serif"'>SURNAME<o:p></o:p></span></h2>
<h2><span lang=EN-GB style='font-family:"Arial","sans-serif"'><o:p> </o:p></span></h2>
</td>
<td width=132 rowspan=2 valign=top style='width:99.0pt;border-top:none;
border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<h2><span lang=EN-GB style='font-family:"Arial","sans-serif"'>FIRST NAMES<o:p></o:p></span></h2>
<h2><span lang=EN-GB style='font-family:"Arial","sans-serif"'><o:p> </o:p></span></h2>
</td>
<td width=222 colspan=2 valign=top style='width:166.5pt;border-top:none;
border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
background:#CCCCCC;padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal align=center style='text-align:center'><span lang=EN-GB
style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal align=center style='text-align:center'><span
style='font-size:12.0pt;font-family:"Arial","sans-serif"'>PROPOSER</span><span
lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p>
</td>
<td width=239 colspan=2 valign=top style='width:179.4pt;border-top:none;
border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
background:#CCCCCC;padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal align=center style='text-align:center'><span lang=EN-GB
style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal align=center style='text-align:center'><span
style='font-size:12.0pt;font-family:"Arial","sans-serif"'>SECONDER</span><span
lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p>
</td>
<td width=234 rowspan=2 valign=top style='width:175.2pt;border-top:none;
border-left:none;border-bottom:solid windowtext 1.0pt;border-right:double windowtext 4.5pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<h2><span lang=EN-GB style='font-family:"Arial","sans-serif"'>SIGNATURE OF
NOMINEE<o:p></o:p></span></h2>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
</tr>
<tr style='page-break-inside:avoid;height:15.6pt'>
<td width=114 valign=top style='width:85.5pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Signature</span><span
lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=108 valign=top style='width:81.0pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Name
in block letters</span><span lang=EN-GB style='font-size:12.0pt;font-family:
"Arial","sans-serif"'><o:p></o:p></span></p>
</td>
<td width=126 valign=top style='width:94.5pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Signature</span><span
lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=113 valign=top style='width:84.9pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Name
in</span><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>block
letters</span><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p>
</td>
</tr>
<tr style='height:27.25pt'>
<td width=136 valign=top style='width:102.3pt;border-top:none;border-left:
double windowtext 4.5pt;border-bottom:solid windowtext 1.0pt;border-right:
solid windowtext 1.0pt;padding:0cm 5.4pt 0cm 5.4pt;height:27.25pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=132 valign=top style='width:99.0pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:27.25pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=114 valign=top style='width:85.5pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:27.25pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=108 valign=top style='width:81.0pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:27.25pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=126 valign=top style='width:94.5pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:27.25pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=113 valign=top style='width:84.9pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:27.25pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=234 valign=top style='width:175.2pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:double windowtext 4.5pt;
padding:0cm 5.4pt 0cm 5.4pt;height:27.25pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
</tr>
<tr style='height:15.6pt'>
<td width=136 valign=top style='width:102.3pt;border-top:none;border-left:
double windowtext 4.5pt;border-bottom:solid windowtext 1.0pt;border-right:
solid windowtext 1.0pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=132 valign=top style='width:99.0pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=114 valign=top style='width:85.5pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=108 valign=top style='width:81.0pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=126 valign=top style='width:94.5pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=113 valign=top style='width:84.9pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=234 valign=top style='width:175.2pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:double windowtext 4.5pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
</tr>
<tr style='height:15.6pt'>
<td width=136 valign=top style='width:102.3pt;border-top:none;border-left:
double windowtext 4.5pt;border-bottom:solid windowtext 1.0pt;border-right:
solid windowtext 1.0pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=132 valign=top style='width:99.0pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=114 valign=top style='width:85.5pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=108 valign=top style='width:81.0pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=126 valign=top style='width:94.5pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=113 valign=top style='width:84.9pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=234 valign=top style='width:175.2pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:double windowtext 4.5pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
</tr>
<tr style='height:15.6pt'>
<td width=136 valign=top style='width:102.3pt;border-top:none;border-left:
double windowtext 4.5pt;border-bottom:solid windowtext 1.0pt;border-right:
solid windowtext 1.0pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=132 valign=top style='width:99.0pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=114 valign=top style='width:85.5pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=108 valign=top style='width:81.0pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=126 valign=top style='width:94.5pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=113 valign=top style='width:84.9pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=234 valign=top style='width:175.2pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:double windowtext 4.5pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
</tr>
<tr style='height:15.6pt'>
<td width=136 valign=top style='width:102.3pt;border-top:none;border-left:
double windowtext 4.5pt;border-bottom:solid windowtext 1.0pt;border-right:
solid windowtext 1.0pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=132 valign=top style='width:99.0pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=114 valign=top style='width:85.5pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=108 valign=top style='width:81.0pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=126 valign=top style='width:94.5pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=113 valign=top style='width:84.9pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=234 valign=top style='width:175.2pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:double windowtext 4.5pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
</tr>
<tr style='height:15.6pt'>
<td width=963 colspan=7 valign=top style='width:722.4pt;border-top:none;
border-left:double windowtext 4.5pt;border-bottom:solid windowtext 1.0pt;
border-right:double windowtext 4.5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal align=center style='text-align:center'><span
style='font-size:18.0pt;font-family:"Arial","sans-serif"'>Under 36 Members</span><span
lang=EN-GB style='font-size:18.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
</tr>
<tr style='height:15.6pt'>
<td width=136 valign=top style='width:102.3pt;border-top:none;border-left:
double windowtext 4.5pt;border-bottom:solid windowtext 1.0pt;border-right:
solid windowtext 1.0pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<h2><span lang=EN-GB style='font-family:"Arial","sans-serif"'>SURNAME<o:p></o:p></span></h2>
</td>
<td width=132 valign=top style='width:99.0pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<h2><span lang=EN-GB style='font-family:"Arial","sans-serif"'><o:p> </o:p></span></h2>
<h2><span lang=EN-GB style='font-family:"Arial","sans-serif"'>FIRST NAMES<o:p></o:p></span></h2>
</td>
<td width=222 colspan=2 valign=top style='width:166.5pt;border-top:none;
border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
background:#D9D9D9;padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal align=center style='text-align:center'><span lang=EN-GB
style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal align=center style='text-align:center'><span
style='font-size:12.0pt;font-family:"Arial","sans-serif"'>PROPOSER</span><span
lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p>
</td>
<td width=239 colspan=2 valign=top style='width:179.4pt;border-top:none;
border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
background:#D9D9D9;padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal align=center style='text-align:center'><span lang=EN-GB
style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>SECONDER</span><span
lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p>
</td>
<td width=234 valign=top style='width:175.2pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:double windowtext 4.5pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<h2><span lang=EN-GB style='font-family:"Arial","sans-serif"'><o:p> </o:p></span></h2>
<h2><span lang=EN-GB style='font-family:"Arial","sans-serif"'>SIGNATURE OF
NOMINEE<o:p></o:p></span></h2>
</td>
</tr>
<tr style='height:15.6pt'>
<td width=136 valign=top style='width:102.3pt;border-top:none;border-left:
double windowtext 4.5pt;border-bottom:solid windowtext 1.0pt;border-right:
solid windowtext 1.0pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=132 valign=top style='width:99.0pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=114 valign=top style='width:85.5pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Signature</span><span
lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=108 valign=top style='width:81.0pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Name
in block letters</span><span lang=EN-GB style='font-size:12.0pt;font-family:
"Arial","sans-serif"'><o:p></o:p></span></p>
</td>
<td width=126 valign=top style='width:94.5pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Signature</span><span
lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=113 valign=top style='width:84.9pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Name
in</span><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>block
letters</span><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p>
</td>
<td width=234 valign=top style='width:175.2pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:double windowtext 4.5pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
</tr>
<tr style='height:15.6pt'>
<td width=136 valign=top style='width:102.3pt;border-top:none;border-left:
double windowtext 4.5pt;border-bottom:solid windowtext 1.0pt;border-right:
solid windowtext 1.0pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=132 valign=top style='width:99.0pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=114 valign=top style='width:85.5pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=108 valign=top style='width:81.0pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=126 valign=top style='width:94.5pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=113 valign=top style='width:84.9pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=234 valign=top style='width:175.2pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:double windowtext 4.5pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
</tr>
<tr style='height:15.6pt'>
<td width=136 valign=top style='width:102.3pt;border-top:none;border-left:
double windowtext 4.5pt;border-bottom:solid windowtext 1.0pt;border-right:
solid windowtext 1.0pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=132 valign=top style='width:99.0pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=114 valign=top style='width:85.5pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=108 valign=top style='width:81.0pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=126 valign=top style='width:94.5pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=113 valign=top style='width:84.9pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=234 valign=top style='width:175.2pt;border-top:none;border-left:
none;border-bottom:solid windowtext 1.0pt;border-right:double windowtext 4.5pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
</tr>
<tr style='height:15.6pt'>
<td width=136 valign=top style='width:102.3pt;border-top:none;border-left:
double windowtext 4.5pt;border-bottom:double windowtext 4.5pt;border-right:
solid windowtext 1.0pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=132 valign=top style='width:99.0pt;border-top:none;border-left:
none;border-bottom:double windowtext 4.5pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=114 valign=top style='width:85.5pt;border-top:none;border-left:
none;border-bottom:double windowtext 4.5pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=108 valign=top style='width:81.0pt;border-top:none;border-left:
none;border-bottom:double windowtext 4.5pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=126 valign=top style='width:94.5pt;border-top:none;border-left:
none;border-bottom:double windowtext 4.5pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=113 valign=top style='width:84.9pt;border-top:none;border-left:
none;border-bottom:double windowtext 4.5pt;border-right:solid windowtext 1.0pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
<td width=234 valign=top style='width:175.2pt;border-top:none;border-left:
none;border-bottom:double windowtext 4.5pt;border-right:double windowtext 4.5pt;
padding:0cm 5.4pt 0cm 5.4pt;height:15.6pt'>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
</td>
</tr>
</table>
</div>
<p class=MsoNormal><span lang=EN-GB style='font-size:12.0pt;font-family:"Arial","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Please
fax, email or post this form, <i>plus the CV of the nominee</i>, back to SAICE
National Office, for attention Mrs Memory Scheepers, by <b><span
style='color:red'>30 July 2010</span>.<span style='color:red'> </span></b></span><span
style='font-size:12.0pt;font-family:"Arial","sans-serif"'>Fax Number : (011)
805-5971; Email: <a href="mailto:mscheepers@saice.org.za">mscheepers@saice.org.za</a>;
Postal address: Private Bag X 200, Halfway House,</span><o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal align=center style='text-align:center'><span lang=EN-US><o:p> </o:p></span></p>
<p class=MsoNormal><o:p> </o:p></p>
</div>
</body>
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