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Welcome to the Official Website of PHAB

To promote Public Health movement in Bangladesh and create a suitable atmosphere for healthful living and thereby promote the growth and development of a healthier nation, Public Health Association of Bangladesh was formed.

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Nomination Form for the PHAB Election

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Nomination Form EC - 2025

Nomination Form for the PHAB Election

Election For: PHAB Executive Committee (EC) Nov. 2025 to Nov. 2027 Date of Election: November 01, 2025

Fields marked with an * are required

Please enable JavaScript in your browser to complete this form.

Section 1: Candidate Information

(To be completed by the Candidate as per Member List)

Instruction:

Please fill out only Section 1 & Section 2.
The remaining sections will be completed by the authorized office.

Click or drag a file to this area to upload.
i.President-1, ii. President (Elect)-1 iii. Vice-President-3, iv. Secretary General-1, v. Joint Secretary-2, vi. Treasurer-1, vii. Organizing Secretary-1, viii. Scientific Secretary-1, ix. Public Relation Secretary-1, x. Members-8 (One candidate can apply for only one position)

Section 2: Proposed and Seconded by

Proposed by:
I, the undersigned, a bonafide member of PHAB in good standing. I hereby propose the candidate named above for the position indicated and endorse his/her candidacy.

Signature & Date

Seconded by:
I, the undersigned, a bonafide member of PHAB in good standing. I hereby propose the candidate named above for the position indicated and endorse his/her candidacy.

Signature & Date

Section 3: Candidate’s Pledge & Agreement

(To be completed and signed by the Candidate)

Instruction:

Please fill out only Section 1 & Section 2.
The remaining sections will be completed by the authorized office.

I, [             Candidate's Full Name             ], hereby affirm that:

• I am a member in good standing of PHAB.
• The information provided in this nomination paper is true and correct to the best of my knowledge.
• I understand the responsibilities of the position. I am seeking and, if elected, I pledge to fulfill my duties to the best of my ability, in accordance with the constitution and bylaws of PHAB.
• I agree to abide by all campaign rules and regulations set forth by the Election Commission.

Candidate's Signature:__________________________________________

Date:                            __________________________________________

Section 4: For Official Use Only - Election Commission

(Do not write in this section)

Received by:_______________________________________

Date Received:____________________________________

Signature of Election Commissioner:__________________________________________

Status:

ACCEPTED: Candidate meets all eligibility requirements.

REJECTED: Reason for rejection: ______________________________________

PENDING: Additional information required: _______________________________

Instructions for Submission: Complete Sections 1, 2, and 3 carefully. You need to pay Tk. 200/- during submission of the Nomination Form.

Secure the required number of signatures from eligible PHAB members in Section 2.

Submit the completed and signed nomination form to the Election Commission at [Temporary Election Commission Secretariat for PHAB Election 2025, Room Number# H9, Department of Non communicable Diseases, Bangladesh University of Health Sciences, 125/1, Darus Salam Road, Dhaka- 1216, cell: 01710972498] no later than [Deadline, Sunday, October 19, 2025, at 5:00 PM].

N.B: Late or incomplete nomination papers will not be accepted.

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