EmailMe Form - MNWT Presidential Medallion Nomination

MNWT Presidential Medallion Nomination

Responses to the online form will be viewed by the MNWT State President three (3) weeks prior to state meeting. Include only offices, projects worked on, certifications completed and information relating to the current year’s activities. Be specific. Use of facts, numbers, and percentages will give a clear picture of nominee accomplishments

Upon completion of the form, click Submit; you will receive a confirmation screen if your form has been successfully submitted. (rev 2020)

Nominee Information
Nominee Name *
First Last
Number of Years a Member
Nominee's Position *
Theme, if applicable
District *
Chapter *
Address

Street Address City State / Province / Region Postal / Zip Code
Nominee Attributes/Accomplishments
Please complete the following to the best of your ability in order to better the chances of your nominee receiving the award.
Number of New Members signed by Nominee this year
Meeting Attendance (Enter "N/A" in both columns, if the nominee did not attend a meeting on the specific level.) *

Number Held Number Attended

Local Board Meetings

Local General Meetings

District Board Meetings

District General Meetings

State Meetings

National Meetings
Local Positions & Impact *
List local officer/program manager positions held and describe impacts or differences made while serving in this position; enter "N/A" if the nominee did not hold a position on the specific level.
District Positions & Impact *
List district officer positions held and describe impacts or differences made while serving in this position; enter "N/A" if the nominee did not hold a position on the specific level.
State Positions & Impact *
List state officer positions held and describe impacts or differences made while serving in this position; enter "N/A" if the nominee did not hold a position on the specific level.
National Positions & Impact *
List national officer positions held and describe impacts or differences made while serving in this position; enter "N/A" if the nominee did not hold a position on the specific level.
New Ideas *
List any new ideas implemented by the nominee in her chapter or in her position.
Encouragement & Incentives *
List and explain how nominee encourages members and offers incentives for participation at district, state, or other meetings and events.
Summary Statement *
Briefly explain how nominee is fulfilling the duties, what challenges the nominee has overcome, and give at least 3 specific reasons why the nominee is deserving of a medallion; include examples of the nominee's accomplishments this year.
Nominator's Information
Submitter Nominator Name *
First Last
By entering your name, you attest that all information provided in this nomination is reliable and true to the best of your knowledge.
Date Submitted
MM / DD / YYYY
Your Email *
Phone
### - ### - ####

	Number Held	Number Attended
Local Board Meetings
Local General Meetings
District Board Meetings
District General Meetings
State Meetings
National Meetings

Nominee Information

Nominee Attributes/Accomplishments

Nominator's Information