FORM 10 APPLICATION FOR NOMINATION OF MEMBER OF COUNTY ASSEMBLY PDU APPLICATION FORM FOR NOMINATION MEMBER OF COUNTY ASSEMBLY REPRESENTATIVE (M.C.A) PARTY OF DEMOCATIC UNITY P.O Box 51748-00200 Tel: 0724-335997 NAIROBI (To be completed in Duplicate) (To be completed in Duplicate)
SECRETARY NATIONAL ELECTIONS BOARD PARTY OF DEMOCRATIC UNITY P.O BOX 51748-00200 NAIROBI PART A 1. Party Gold Membership No 2. Electors Card No 3. National Identity Card No. 4. Physical Address... 5. Postal Address 6. Telephone 7. Email Address 8. Sub location/kijiji 9. Ward 10. Constituency 11. County PART B: PARTICIPATION IN PARTY PROGAMS 1. How long have you been a Member of the Party?... 2. Provide evidence of your performance in the management of Party programs in your ward? Are you a member of any organ of the Party?... 3. Briefly state your commitment and passion to the party, its ideology, policies and programs. And how you want the party to support you 4. Can you be described as a disciplined and dependable party member? Please illustrate in two hundred and twenty words.
PART C: 1. Demonstrate your capacity to mobilize the grassroots for the Party to win in the General Elections. Have you ever been elected or nominated in any civic authority/ward? YES/NO Have you ever served in any public or private sector? YES.NO PART D: LEADERSHIP AND INTEGRITY 1) Have you at any time within five years immediately preceding the date of election, held office as a member of a Commission? 2) Have you ever been declared bankrupt?... 3) Have you ever been convicted in a court of law on a criminal offence/abuse of office or in any other way contravened Chapter Six of the constitution of Kenya?.. PART E Please submit your application with the following 1) A non-refundable nomination fee of Kenya Shillings Twenty Thousand (Ksh. 20,000) payable by Bankers Cheque to Party of Democratic unity or deposit in the Party s Account 2) a) Certificate of Secondary education b) Certificate of Post-secondary education 3) A copy of your National Identification Card 4) 2 copies of passport (photograph) 5) A copy of your Elector s card 6) A copy of your Party of Democratic unity Gold Membership Card 7) Duly executed Code of conduct and pledge of commitment. Dated At. This day of..2013. SIGNATURE FULL NAMES OF CANDIDATE NB:Please submit your application with a copy of the receipt for the application fees duly paid... For Official Use only Receipt No: Date Approved By NEB... Date.
PARTY OF DEMOCRATIC CODE OF CONDUCT AND PLEDGE OF COMMITMENT. I being an aspiring candidate for member of county assembly in Ward Constituency County do hereby subscribe to the Party of Democratic Unity Code of Conduct and pledge of commitment and solemnly declare as follows; that I 1. Shall respect, uphold and defend the Party Constitution, Party Election and Nomination Rules, Manifesto and any other Party rules and regulations. 2. Shall observe this Code of Conduct pursuant to the Constitution of the Republic of Kenya, the Political Parties Act and any other Electoral Laws. 3. Shall respect all Party Organs, the Party Leadership, preserve and protect the good image of the Party; 4. Shall uphold and promote good Governance, Patriotism, National Reconciliation, Integrity, Cohesion, Respect, Tolerance, Transparency, Accountability; Rule of Law and National Unity; 5. Shall respect and promote human rights, fundamental freedoms, human dignity, equity, social justice, inclusiveness and non-discrimination and protection of the marginalized; 6. Shall respect and uphold the democratic rights of other members in competition for political power. 7. Shall promote consensus building In decision making on issues of national importance that affect the Party; 8. Shall respect and promote gender equity and the right of all persons to participate in the political process including the Youth, Minorities and the Marginalized groups; 9. Shall Respect, uphold and promote democratic values, the principles of free, fair and credible elections within the Party organs and the principles of leadership and integrity as enshrined in the Constitution of the Republic of Kenya. 10. I further avers that I shall not a. Engage in or encourage violence intimidation of/or by Party members, opponents, supporters or any other person or other Political Parties; b. Engage in/or influence peddling, bribery or any other form of corruption and accept or use illicit or illegal money; c. Advocate hatred that constitutes ethnic incitement, vilification of others or incitement to cause harm; d. Obstruct, disrupt, break-up or in any other way whatsoever interfere with any political meeting, rally or demonstration of another political party or its leadership e. Establish or maintain a Para-Military force, militia or similar organization or have any links with such organizations;
f. Use state resources for partisan campaigns; g. Carry or allow weapons and/or machetes to be carried at political meetings and polling centers; h. Publish or report false, defamatory or inflammatory allegations about political opponents i. Prevent eligible voters from having access to political opponents; j. Discriminate on the basis of race, sex, ethnicity social class or religion; I hereby pledge:- 1) My loyalty and commitment to my Party and its leadership 2) Adhere to Party policy and programs for the entire duration that I shall be a member of the Party. 3) Not to support any candidate after my nomination as a party candidate and I shall be required to pay to the party a sum of money if I support another candidate not sponsored by(pdu) 4) To contribute to the Party such monthly contributions as may be set upon after my election as Member of the County Assembly. 5) Take all reasonable steps to protect members of the National Elections board and other election officers in their course of duty. 6) Take necessary and reasonable steps to instill discipline of my agents and supporters. Any member who evidently defaults on the above shall be subject to:- i. Disciplinary action by the Party ii. Denial by party of Democratic Unity of its ticket for candidature. iii. Denial of Party of Democratic Unity elective position. This declaration is made to the best of our knowledge, information and belief. DATED THIS DAY OF..2017 Signed by: Name of Candidate. Signature. In the presence of COMMISSIONER FOR OATHS/MAGISTRATE