Nomination Form

You must be a member in good standing to nominate an organization and your organization must have been a 501(c)3 for at least a year.

Please complete the information below and submit this form at least two days before the meeting. You can also send it by fax to 207-797-7287, by mail to Deb Bergeron, 7 Pine View Rd, Falmouth, ME, 04105 or by email to

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Please include the organization's mission statement, populations served, other sources of funds, how funds are used, and any other pertinent information below:

The organization agrees to not use, give, or sell the contact information of our members for additional solicitation by them or other organizations. Initial here: