Provincial Board Candidate Information - 2018 Synod

1. Deadline for Submission is November 13, 2017.

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* 1. Please provide your personal information.

Name:

Congregation:

Address:

City/Town:

State:

ZIP/Postal Code:

Occupation (if retired, give former):

Email Address:

Phone Number:

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* 2. To which board or agency do you seek nomination? (If interested in more than one board, please complete a separate candidate information form for each board to which you seek nomination.) Use the separate "PEC Candidate Information Form" if interested in Provincial Elders' Conference.

Board of Directors, Board of World Mission

Board of Directors, Moravian Mission Society

Board of Trustees, Moravian Theological Seminary

Board of Trustees, Salem Academy and College

Board of Directors, Salemtowne

Provincial Women's Board

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* 3. Why do you wish to be nominated to this board?

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* 4. What special abilities/traits/interests do you offer to this board?

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* 5. Please list all present and past activities in your local Moravian Congregation as well as any involvement in the larger Moravian Church (Provincial, Interprovincial, Unity). Please include dates of service (for example: Chair, Board of Trustees, Calvary Moravian, 1992-1995).

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* 6. Please list any other relevant past or present community service or work experience. Please include dates of service.

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* 7. Additional comments or qualifications:

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* 8. Affirmation of Candidacy:
I understand the duties of and qualifications for membership on the board to which I may be nominated. If nominated and elected, I will serve to the best of my abilities and will be faithful in attending meetings.
Do you agree to the above-mentioned affirmation of candidacy?

No, I do not agree

Yes, I agree to the affirmation of candidacy (type your name and the date below):

When finished, click "Done" to submit your completed form, NO LATER THAN November 13, 2017.

Photo Request
We ask that you provide a recent full color photo of yourself in a separate JPEG attachment. Your photo should be a current, high-quality headshot, suitable for publication. It should be at least 300 dpi in resolution. Please email your photo file to bjohnson@mcsp.org OR mail your photo to the address above along with your form.

Questions?

Contact Committee Co-Chairs Cheryl Cottingham (336-749-3906 or
cottingreen@outlook.com) or Neil Routh (336-786-5627 or nrouth@gracemoravianchurch.org).

Thank you!
-Nominations Committee, Synod of 2018