Honorary State Degree Nomination Application

Honorary State Degree Nomination

State FFA Application
Application Information
This form is to make a nomination for the Honorary State FFA Degree. One nomination can be made per chapter per year. The State FFA Executive Board can nominate up to three people for the Honorary State FFA Degree and will select up to three from chapter nominations. The Honorary State FFA Degree is for individuals.

THIS APPLICATION MUST BE COMPLETED BY AN ADVISOR.
Date of Convention to be Awarded*

MonthDayYear
Date

Individual Information

This information pertains to the Chapter Advisor completing this form. All information on this page is in relation to the chapter FFA advisor.
Name*

First NameMiddle NameLast Name
Personal Phone*
Personal Email*
School & Chapter Information
School Name*
School Phone*
School Address

Street Address

Street Address Line 2

CityState

Zip Code
Chapter Name*
Chapter Number*

Award Information
App Year Date String
App Year FINAL
You are submitting an Honorary State Degree Nomination for the application year

{appYear}
Name of Nominee*

PrefixFirst NameLast Name
Title of Nominee*
Occupation of Nominee*
Email of Nominee*
Be sure this email is used by the contact.
Phone Number of Nominee*
Address of Nominee*

Street Address

Street Address Line 2

CityState

Zip Code

Receipt of Honorary Chapter Degree*

	Chapter Degree	Year Received (N/A if not)
Details

Nomination Writing
List major contributions nominee has made to the agricultural education/FFA program.*

min. 60 words/max. 180 words0/180
Discuss contributions nominee has made to the local chapter which affect the State FFA Association.*

min. 60 words/max. 180 words0/180
Indicate nominee's major accomplishments in other organizations which relate to the FFA/Ag Ed program.*

min. 60 words/max. 180 words0/180
Advisor Certification
Advisor Key*
Use the Advisor Key provided by the State to access the signature section.
Certification*

I certify that I am the advisor to the chapter named on this application form and have provided my signature below.
Advisor Signature*

Clear

Submit

This is for FINAL SUBMISSION only. If you wish to edit your responses at a later time, DO NOT click submit.
Should be Empty:

Application Information