Minnesota Women of Today

This online form will be sent directly to the State President upon submission. This form must be completed three (3) weeks prior to the state meeting. Upon completion of the form, click Submit; you will receive a confirmation screen if your report has been successfully submitted. Indicates a required field
Medallion Type:		Presidential State Delegate
District Number:		Area:
Nominee Information
Nominee's Name:
Date Nominee Joined:
Nominee's Address:
Nominee's Theme (if applicable):
Chapter:		Size:
Include only offices, projects worked on, certifications completed and information relating to this year's activities. Be specific. Use facts, numbers and percentages to give a clear picture of nominee's accomplishments.
Local Meetings Held:		# Attended:
District Meetings Held:		# Attended:
State Meetings Held:		# Attended:
Local Positions Held (current year):
District Offices Held (current year):
Certifications Completed (current year):
Othis/her Statewide Events Attended (current year):
Number of new members signed by nominee:
List any new ideas implemented by nominee in his/her chaper or position:
Explain how nominee fulfills his/her duties, what challenges she has overcome and why the nominee deserves the medallion:
Nominator Information
Your Name:
Your Position:
Email Address:
Phone:
Chapter:
Trimester:		1 2 3
Click here to submit the form:

Nomination: Presidental & State Delegate Medallion