Nominating petitions shall be in substantially the following form and the information thereon shall be verified by the county election commission:
We, the undersigned registered voters of the state of Tennessee and members of the (respective) party, hereby nominate (candidate's name), (address) of ____ County, as a candidate for delegate to the national convention of the (respective) party to be voted in the presidential preference primary election to be held on the ____ day of March. We request that the above nominee's name be printed on the official ballot as a candidate for delegate (at large) or (from the ____ congressional district).