Page 25 - Syn-Lod 2017 Conference Guide v2
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“Investing In V.A.L.U.E.S. that Support, Enhance and Sustain”
TOP LADIES OF DISTINCTION, INC.
SYN-LOD 2017
Memorial Roll Call Form
Please complete this Memorial Roll Call Form for Top Ladies, Top Teens or Lords that are to be recognized dur-
ing the 2017 Syn-Lod memorial ceremony. Please duplicate this form, if needed. Please send a photo of the de-
ceased. Submit completed form and photo of the deceased electronically to pamp330@aol.com . If an electronic
submission is not possible, please submit to:
Lady Pamela Bates Porch- National Chaplain
1407 West 73rd Street
Chicago, Illinois 60636-4005
Submission Deadline Date: June 1, 2017
Please Print
Chapter President_______________________________________________________________ Area_______
Email Address________________________________________________Phone________________________
Area Director______________________________________________________________________________
(Circle One Per Entry)
1. Name ______________________________________________ Lady Lord Teen
2. Name_______________________________________________ Lady Lord Teen
3. Name _______________________________________________ Lady Lord Teen
4. Name _______________________________________________ Lady Lord Teen
5. Name ______________________________________________ Lady Lord Teen
Chapter President Signature_______________________________________ Date _____________________
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For Office Use Only
Date Received ____________________________________________ Initialed ______________________
**You will receive an email confirmation when the completed form and photo is received.
TLOD 40th Syn-Lod ~ June 23 - June 29, 2017 25 2017 Conference Guide
