Lone Star Chapter 124’s “David Tips Volunteer of the Year Award”

Nomination Form

Note:  This is a Lone Star Chapter 124 award and contributions to the Chapter are what are most important!

Nominee Name:
Nominee Address:
 

Offices Held and Years of Service (This information can be found on the Chapter Web Page under Officers):

Chapter Level:
 

Participation on a Committee, Chairmanships, Special Services, Certificates/Awards, and/or other Contributions:

Chapter Level:
Lone Star Regional Level:
National Level/National Conventions as related to the Chapter only:
 

Lectures, Workshops, Seminars, Educational Classes or other Chapter related activities that have promoted Education to Lone Star Chapter 124’s membership:

List Activities:
 

Publications, Newsletter Articles, Newspaper Articles or other writing that helps Promote Horology and Lone Star Chapter 124.

List Publications:
 

Please state why this person is the most deserving of this award. Feel free to have other members endorse this nominee with a letter.

Why Most Deserving:

 

Your Information:

Nominated By:
Your NAWCC #:
Your Address:
Your Email Address:
Your Phone #:

This form must be printed and mailed to the DTVY Selection Committee

 

Nominations are due to Pam Tischler at FSWProgram@verizon.net by February 1, 2017.