Nomination Form can be filled out and submitted online or downloaded and mailed to the address at the bottom of the form.

Nomination Form Deadline: April 15, 2017

Nominator’s Contact Information

Name
Phone Number
Address
I would like to remain anonymous to the person(s) I nominate.
If we need to contact you, which would you prefer?

Nominee’s Contact Information

Name
Phone Number
Address

Nominee’s Details

Please help us by answering the following to the best of your ability and awareness:

How long and under what circumstances have you known the nominee?

Describe the nominee’s involvement in his/her church, school, or community, paying particular attention to his/her interest in religious, theological, or social issues, and the maturity of his/her spiritual development.

Please comment on the nominee’s intellectual abilities, including creativity, curiosity, independence of thought, ability to follow through on responsibilities, and ability to explore and communicate ideas within a context of diversity.

What are the nominee’s ways of relating to others (peers and adults), reacting to stress, and typical means of resolving conflict?

Please provide any information about the nominee’s family and home life, or other information that you think might be relevant?

What makes this nominee unique?

Additional pertinent information about the nominee (if applicable)