Refugee Congress Delegate Nomination Form
Form to nominate candidates for empty state seats
Name and State of Nominator:
Nominator Contact Information (phone and email):
Name and State of Nominee:
Nominee Contact Information: Mailing Address, Phone/Cell, and Email
Nominee Gender/Gender Identity and Year of Birth
Nominee Country of Origin and Year of Arrival to US:
Please check if Nominee is:
For Nominators, please briefly describe how you know the Nominee and why you believe the Nominee will be an effective Delegate to the Refugee Congress, including a brief description of their community service, leadership, and advocacy experience.
Please upload here the Nominee's Personal Statement here.
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