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Nominee Information Form

For the Nominating Committee of Standing Committee

Someone has nominated me, and I am willing to be considered as a candidate for the office of
 

Full Name
Age
Address
City
State
Zip
Home Phone
Cell Phone
E-mail Address

Occupation
Congregation
District
Gender  
Racial/Ethnic Background  
 

Leadership positions you have held in the LOCAL Church

max 1000 characters
Leadership positions you have held at the DISTRICT level

max 1000 characters
Leadership positions you have held at the DENOMINATIONAL level

max 1000 characters
OTHER relevant leadership positions (community, professional, etc.)

max 1000 characters
Describe how these positions will provide you with the skills/experience needed for this nominated office

max 255 characters
Please limit your response to the following to one sentence each.

Your VISION

Your PRIORITY

Your FAITH STATEMENT

Signature (typed)
     

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Phone: 800-323-8039, ext 364 or 365 | annualconference@brethren.org