Uptick Baptist Women Nominator's Form

Use this form to nominate a young women leader for the upcoming calendar year. All nominations are due by November 1st each year.

Nominator's Full Name*
First Last
Nominator's Church*
Nominator's Email Address*
Nominator's Phone*
Candidate's Full Name*
First Last
Candidate's Email Address*
Candidate's Phone*
Candidate's Birthday*

Day
Month
Year
Candidate attends this CBOQ church*

Give name of church + address
Candidate's education and major*
How long have you known the candidate?
Share 1 - 2 examples of the candidate's leadership in action that you have seen, and how you have seen her begin to grow and use her gifts as a Kingdom LEADER
Share those examples here.
Please provide 1 reference person (other than you) and that person's contact information. (That reference could be a pastor, co-worker, ministry leader.)*
Name of second reference | Email Address | Phone
Would you like to receive our monthly newsletter - the ELINK?*
Let us know if you'd like to receive regular updates about our resources and our work.
Date
MM slash DD slash YYYY