Lead Conference Minister Nomination Form
 Nominee
Please provide as much information below as you are able. This information will be received and reviewed only by the Search Committee. Thank you!
Name of nominee
Place of employment (if employed)
Nominee's e-mail address
Address
City
State
-Please select a state-
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennesse
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Guam
Puerto Rico
US Virgin Islands
Armed Forces Africas
Armed Forces Americas
Armed Forces Canada
Armed Forces Europe
Armed Forces Middle East
Armed Forces Pacific
Zip
Home Phone Number
Cell Phone Number
What qualifications do you think this person would bring to the position?
 Your contact information
Your name
Your e-mail address
Your phone number
Additional comments