Nomination Form Odd Year
Are you nominating yourself or someone else? If someone else, please obtain their consent prior to submitting a form.
 Other, consent obtained
Nominated for the office of: (check all that apply)
 Spiritual Growth-Mission Awareness Coordinator
 Pastoral Advisor
First Name:*
Last Name:*
Zip/Postal Code:*
Phone Number:*
E-mail address:*
Please provide a brief description of your computer skills:
What is your occupation?
Marital Status:
If married, spouse's name:
Family members:
Name and address of nominee's congregation:*
Name of nominee's circuit:
Please describe the nominee's LWMS activities, positions and organizational involvement in the present and past:
Please describe the nominee's service to the local congregation in the present and past:
Please provide professional, work or volunteer experience which relates to the duties of the office for which this person is being nominated:
Please provide any other information which may help form a "mental" picture of the individual, and be of benefit to the board of directors in assessing the talents and capabilities of this nominee:
Upon receipt of this nomination form, you will receive an email. Please attach a recommendation provided by the pastor or the nominee's home congregation or the District President in the case of nominees for Pastoral Advisor and return to sender.
Nominations are due by January 1, 2021. Thank you for your nomination.
Submitted by:*
Phone number:*
E-mail address:*
Congregation name, city and state: