George E. Brown Nominating Form

Irene J. Washington
District #1 President

INTERDENOMINATIONAL CHURCH USHERS ASSOCIATION OF VIRGINIA, INC., DISTRICT #1

                          2011 GEORGE E. BROWN AWARD NOMINATION FORM
IMPORTANT NOTICE:
Please see the attached Amendment to the George E. Brown Award Guidelines for complete instructions. All information must be typed.
NOMINATION FORM DUE DATE:
This nomination form must be postmarked no later than September 30, 2011 or in the possession of the chairperson and/or a committee member no later than September 30, 2011. If you mail this form, please mail the form to the chairperson at the following address: Cheryl D. Allen | 2468 Garnett Drive | Alexandria, Virginia 22311. If you email this form, please email the form to the chairperson at the following email address: Cheryl.Allen0913@comcast.net.
NOMINEE INFORMATION:
Last Name: First Name:
Street Address:
City | State | Zip Code:
Telephone Number: Email Address:
Church:
Are you an active member of your Church Usher Ministry? (Yes or No):
Have you attended a minimum of two District #1 Meetings from September 1, 2010 through August 31, 2011? (Yes or No):
Have you attended a minimum of 15 District #1 Annual Ushers Days from September 1, 2010 through August 31, 2011? (Yes or No):

Nominee Signature:
NOMINATOR INFORMATION:
Last Name: First Name:
Street Address:
City | State | Zip Code:
Telephone Number: Email Address:
Church:
Nominator Signature:
REASON FOR NOMINATING THE NOMINEE:
(If you need additional space, please continue your write-up on a separate page and attach it to this form.)


CHURCH USHER MINISTRY PRESIDENT OR VICE PRESIDENT SIGNATURE:
(If the Church Usher Ministry President is the nominee, the Church Usher Ministry Vice President must sign.)
Name:
Signature:
AWARD RECIPIENT ANNOUNCEMENT:
We will announce the award recipient at our Christmas Fellowship on December 2, 2011.