2023 DISTRICT LEVEL ELECTIONS IN GHANA As published by the Electoral Commission of Ghana: In accordance with the District Level Elections Regulations, 2015, (C.I 89), the Electoral Commission will conduct the District Level Elections on the 19th of December, 2023. This follows the expiration of the term of the Assembly and Unit Committee Members on the 17th December, 2023. Nominations Forms may be obtained free of charge at the District Offices of the Electoral Commission across the country or on the website of the Electoral Commission.

1. NOMINATION FORM
We, the undersigned, Medical and Dental Practitioners, Physician Assistants or Certified
Anaesthetists do hereby nominate the following person to represent Medical/ Dental/Physician
Assistants/Certified Anaesthetists. (Underline where applicable)
S U R N A M E OTHER NAMES A D D R E S S
Contact Number:
2. Proposer: Name:……………………………………………….. Address:……………………………………..
Signature:………………………………………….. Contact No:……………………………….
Seconder: Name:………………………………………………… Address:……………………………………..
Signature:…………………………………………… Contact No:……………………………….
3. I the undersigned, Medical/Dental/Physician Assistant/Certified Anaesthetist hereby support
the nomination of…………………………………………………………………………………………………………
Supporter: Name:………………………………………… Address:…………………………………….
Signature: …………………………………………………… Contact No: ………………………………
I, the undersigned, Medical /Dental/Physician Assistant/Certified Anaesthetist Practitioner
registered, hereby consent to my nomination for election to the Medical and Dental Council as
a representative of Medical/Dental/Physician Assistant/Certified Anaesthetist.
………………………………………….
Signature
Date:…………………………………………………