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(Please exclude paid staff)

I. Name: ___________________________________________________________________________________

Address: _________________________________________________________________________________

City: ______________________________________ State: __________ Zip: __________________________

Telephone Number: ( ) ____________________ Email: ____________________________________

Church: ________________________________________________ District: __________________________

Size of Church: 1-99 100 - 249 250 - 400 500 - More

II. LAITY How long has this person been a member of this church? _________________________________

List areas where he/she has evidenced leadership in evangelism and in the making of Disciples of Jesus Christ:

1. ______________________________________________________________________________________


2. ______________________________________________________________________________________


3. ______________________________________________________________________________________


III. Describe the “spirit” of the person you have nominated. Give a brief biography, tell about the person’s attitude
toward life, his/her Christian commitment, and the person’s vision for the future. (You may use additional paper.)

IV. Describe the “fruits” of the spirit displayed by this person. What difference has this person made in the lives of
people, the church, and the community. (You may use additional paper.)

V. Other comments or information you believe would be helpful to the selection process.

VI. Please attach a letter written by the Pastor of the person you have nominated.

VII. Person making nomination: _________________________________ Position: _______________________

Address: __________________________________________City: __________________________________

State: ___________ Zip:_________________ Telephone: ( ) _________________________________

Email Address: ___________________________________________________________________________

VIII. Mail this form by: May 5, 2008

TO: Tennessee Conference, 304 S. Perimeter Park Dr., Suite 1, Nashville, TN 37211: Attention Vicki Sharber