May 15-18, 2017
University of Missouri
Nomination Form Information
For the ONLINE nomination form, click the link below, please be prepared to answer the following questions:
- Nominee’s Full Name (First and Last Names)
- Name as it should appear on nametag
- Office street address, city, state, postal code, country
- Daytime phone
- Email address
- Name of cooperative
- Cooperative’s website
- Cooperative street address, city, state, postal code, country
- Name, title and email of Person writing nomination letter
- Is nominator a past participant of GICL Summer Institute?
Information provided below will be used to prepare a brief biological statement about the nominee.
a. Up to 4 institutes
b. Each Institute’s name, graduation date, area of emphasis and degree
- Work Experience – please begin with current position
a. Up to 5 previous positions (fill in however many preferred)
b. Each Position’s Position/Title, Firm/Organization, date
- Total Years in job force
- Total years working with a cooperative
- Total years working with This cooperative
- Hobbies and leisure hour pursuits
For a FILLABLE and PRINTABLE Nomination form, click the link below.
To use the fillable features of the PDF Nomination form:
- Open the online nomination form PDF (link below)
- Save the blank nomination form to your computer
- Open the nomination form on your computer and fill out the form
- Re-save as completed to your computer
- Return completed nomination form to email@example.com.
Filling out the information while in the browser does NOT retain your information.