Nominee’s name Nominee’s mailing address Nominated for Award: Life Member Certificate of Recognition Nominee’s email address Letter of Thanks Nominee’s phone Nomination submitted by (Member State) Nomination approved by Name Signature Date nominating Member State’s Executive Committee President Or ACF Sub Committee Secretary Member State’s contact person Contact persons phone Contact persons email
Nominated for Award: Life Member Certificate of Recognition Letter of Thanks Nominee’s name Nominee’s mailing address Nominee’s email address Nominee’s phone Nomination submitted by (Member State) Nomination approved by nominating Member State’s Executive Committee Or ACF Sub Committee Name Signature Date President Secretary Member State’s contact person Contact persons phone Contact persons email