ZONTA INTERNATIONAL > Member Resources > Tools > Club Tools

Length of Membership Award Nomination Form

Please complete the nomination form in English. The nomination should be submitted to Zonta International Headquarters six (6) weeks in advance of the presentation date. The Zonta International Board has authorized the Executive Director to approve Length of Membership Awards. A special individualized certificate will be provided and sent to the club president for presentation.

PROPOSED RECIPIENT:

Proposed Recipient's First Name:*

Proposed Recipient's Last (Family) Name:*

Proposed Recipient's Mailing Address:*

Proposed Recipient's Zonta Club:*

Proposed Recipient's Club Number:*

Proposed Recipient's District Number:*

Year Proposed Recipient Joined Zonta:*

Years of Membership:
25 years
30 years
35 years
40 years
45 years
50 years

Highest Zonta Office Held by Proposed Recipient:

Zonta Service Given by Proposed Recipient:

Suggested date/event/venue of presentation:*

THE RECIPIENT IS PROPOSED BY:

Proposer's First Name:*

Proposer's Last (Family) Name:*

Proposer's Telephone Number:

Proposer's Fax Number:

Proposer's Email Address:*

Proposer's District Number:*

Governor's Name:*

I have consulted with my Governor, and she has approved the submission of this proposal.:*