Nominee Form District At Lg to AC

NOMINEE FORM
Eastern Shore District Member At-Large
to 2022 Annual Conference Session, June 16-18, 2022 in Hampton
(Nominees to be elected at the August 22, 2021 District Conference, 4-6 pm at Franktown UMC

Per diem approved for District Members for travel and hotel accomdations is $400.

Deadline is Wednesday August 15, 2021

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Select One *

The District Conference elects 2 Young Persons, 2 Youth, 8 District At-Large Members
(All nominees shall have been members of The United Methodist Church for the two years preceding their nomination and shall have been active participants in The United Methodist Church for at least four years preceding their nomination ¶602.4, 2016 Book of Discipline)

Name *

First

Last

Mailing Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Church *

Please list brief summary of offices/leadership positions in the local church , district and conference. Information will be included on the ballot or summarized if necessary. *

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