Page 9 - 2017 TLOD Candidate Bulletin
P. 9

TO P  LA D I ES   O F   DI S T I NCT I O N ,  I NC.
                                 NATIONAL OFFICIAL FLOOR NOMINATION FORM

                                Recorded information MUST address the Candidate Eligibility Requirements & be legible

                            Submit to National Nominating Committee Chair: Lady Dorothy Fisher
                          { For Pre-Certification, submit by email to spikedjf@aol.com by June 1, 2017 }


          Name: ____________________________________________________         Area: ____________
          Address: __________________________________________________        Chapter: __________________________
          City: _____________________________ State: ______    Zip: _______   #Years With Present Chapter: _________
          Contact Phone #: ________________________                          #Years Active TLOD: _______________
          Email: __________________________________________________


          National Office / Position Applying For: ______________________________________________________

          Educational/Professional Background:




                                                     SERVICE TO TLOD
                        LOCAL                                AREA                             NATIONAL
                                               OFFICES OR POSITIONS HELD





                                                       COMMITTEES





                                      CONFERENCES ATTENDED (Record Specific YEARS)






            _________________________________           _______________
                    Nominee’s Signature                      Date
          _________________________________             _________________________________          _____________
                  Chapter President’s Name                 (1) Chapter President’s Signature            Date
          _________________________________             _________________________________          ______________
                    Chapter Financial Secretary’s Name         (2) Chapter Financial Secretary’s Signature       Date

          (1) President’s Signature confirms the nominee is an active chapter member eligible for the position being sought as
             specified under “Syn-Lod Elections” in the TLOD Standard Operating Procedures Manual.  Not more than two ladies
             from the same chapter may be candidates for national officer positions in the same election.
          (2) Financial Secretary’s Signature confirms the nominee is an active chapter member in good financial standing with the
             chapter.
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