May 15-18, 2017
University of Missouri
Columbia, Missouri

Nomination Form Information

For the ONLINE nomination form, click the link below, please be prepared to answer the following questions:

Online Nomination Form

  1. Nominee’s Full Name (First and Last Names)
  2. Name as it should appear on nametag
  3. Office street address, city, state, postal code, country
  4. Daytime phone
  5. Email address
  6. Name of cooperative
  7. Cooperative’s website
  8. Cooperative street address, city, state, postal code, country
  9. Name, title and email of Person writing nomination letter
  10. Is nominator a past participant of GICL Summer Institute?

Information provided below will be used to prepare a brief biological statement about the nominee.

  1. Education
    a. Up to 4 institutes
    b. Each Institute’s name, graduation date, area of emphasis and degree
  2. 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
  3. Total Years in job force
  4. Total years working with a cooperative
  5. Total years working with This cooperative
  6. 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:

    1. Open the online nomination form PDF (link below)
    2. Save the blank nomination form to your computer
    3. Open the nomination form on your computer and fill out the form
    4. Re-save as completed to your computer
    5. Return completed nomination form to

Filling out the information while in the browser does NOT retain your information.

Fillable and Printable Nomination Form