Information about the nominee:

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Title

Information about the nominee's place of ministry:

Congregation/agency
Street Address
Address (cont.)
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State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail
URL

Information about the nominee's residence:

Street Address
Address (cont.)
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Country
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Briefly state why you believe the nominee should be named 2007 LEA Leader in Outreach. Please use the criteria at the top of the page to guide your comments

Please tell us about yourself:

Name
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