Official
Nomination Form
(PLEASE TYPE OR PRINT NEATLY - REMEMBER, IN ORDER
TO QUALIFY, ALL INFORMATION MUST BE FILLED OUT.)
Nominee's Name Street Address
City State Zip Code
(Area Code) Phone (Area Code) Cell Phone (Area Code) Daytime Phone
Date of Birth Occupation
Business Address: City State Zip Code
Nominee Background Information: Please provide brief information regarding personal life, such as family, education, interests, hobbies, etc.
Nominee Photograph: Please include a recent photograph of the nominee. Minimum size: wallet size (2x3); maximum size: 5 x 7. All photographs will be returned if a Self-addressed stamped envelope is included (no group photos please).
NOMINATOR’S INFORMATION
Name: Relationship to Nominee:
Address: City State Zip
E-mail Address: Daytime Telephone:
Cell Phone:
Signature:
Print out the form and mail with picture to:
Contest
P.O. Box 9148
Jacksonville, FL 32208
Phone: 904 733-5724 FAX: 904 733-5725
REASON FOR NOMINATION: Please list only volunteer work for which there was no compensation and can be documented/verified. Include dates, length of service and accomplishments.
CONTEST RULES
Purpose:
To honor Godly Women for their extraordinary Influence in the lives of those around them
To encourage and inspire other women to become a woman of Godly influence
Qualifications:
The individual must be 18 years of age or older
The individual must be a resident of the state of Florida
The individual cannot be compensated for her deeds or service
Nomination Process:
Nominations will be accepted through April 19, 2008
Nominations must be made on an official nomination form and sent to: Influence of a Godly Woman Contest, P.O Box 9148., Jacksonville, FL 32208
Nominations must include a photograph of the nominee
Winners will be announced at the book signing May 3, 2008 at Fusion Bookstore (formerly Gospel World in Arlington), between Noon and 2:00 P.M.
Prizes & Awards:
Grand Prize: $250 Shopping Spree and lunch with Dr. Diane Clark, author; A Day at the Spa; Featured guest on Wisdom For Winning Community Talk Show and more . . . .
First Runner-Up: Autographed copy of the book and Mother’s Day gift surprises; A Day at the Spa ; Toiletry gift basket; Interview with personal trainer; Much more . . .
Second Runner-Up: Autographed copy of the book; Manicure/Pedicure; and much more . . .
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