Nomination Form for Lay Delegation to the General and Jurisdictional Conference

*First Name
*Last Name
*Church:
*District:
*Experience and Qualifications:

Please provide a brief statement on the nominee’s church experience and qualifications.

*Age:
Number of terms as General/Jurisdictional delegate (if applicable):
*Ethnic Background:
Attach a Photo:

Photo cannot be larger than 2"x3".

Attach file pdf, doc(x), xls(x), jpg/gif/png, ppt - up to 25 MB

*Submitted by:

Please enter name of person submitting this nomination.

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