Sample Trustee Nomination Petition: School District Public Library

Requires 25 signatures or 2% of the number of votes cast in the last annual school election, whichever is greater

I, the undersigned, do hereby state that I am a duly qualified voter of the XXXXXX Central School District, that I was registered to vote therein at the time of the last preceding general election, that my present place of residence and my place of residence at the time of the last preceding general election are truly stated opposite my signature hereto, I intend to support at the ensuing district meeting, and I do hereby nominate the following named person as a candidate for nomination for the public office of member of the board of trustees of the XXXXXX Public Library (only one of seven seats elected at large), to be voted for at the district meeting to be scheduled for this purpose:

Name of Candidate

Public Office

Place of Residence

MEMBER OF THE BOARD OF TRUSTEES OF THE XXXXXX PUBLIC LIBRARY

(for up to a five year term)

In witness whereof, I have hereunto set my hand, the day and year placed opposite my signature

#

Date

Name (print)

Signature

Address

Election District

1

_______

_______

_______

_______

_______

2

_______

_______

_______

_______

_______

3

_______

_______

_______

_______

_______

4

_______

_______

_______

_______

_______

5

_______

_______

_______

_______

_______

Continue table to accommodate required number of signatures

STATEMENT OF WITNESS

I, _________(Name of witness) state: I am a duly qualified voter in the State of New York and now reside in the (City, Town or Village of ___________ in New York State, at ________________________________(Address) therein. I was last registered for the general election in the year ____ from __________________, the County of ___________ in New York State. The said residence was then in the _______ (Election District) in the __________________(Town in outside the City). I know each of the voters whose names are subscribed to this petition sheet containing ________ signatures, and each of them subscribed the same in my presence and upon so subscribing declared to me that the forgoing statement, made and subscribed by him, was true.

Date ______________________ Signature of Witness ___________________________


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Last Updated: July 28, 2009 -- asm [created January 27, 2005]; for questions or comments, contact us