Bob Joslin Young Leader Award

Bob Joslin Award

Nomination Form

2015

(Please type)

Name Phone

Address

(route/street) (town) (zip)

Spouse name

(if married)

Children: Boys _____ Ages _____ _____ _____

Girls _____ Ages _____ _____ _____

E-mail Cell

Number of years a Farm Bureau member __________

Type of farming operation

ELIBILITY REQUIREMENTS: Farm Bureau member in good standing, age 18-35 in 2015, actively engaged in agriculture.

Nominated by _________________________ County Farm Bureau

Signed Date

(county president)

Return by August 31, 2015 to:

Mary Foley Balvanz

Leadership Training Manager

Iowa Farm Bureau Federation

5400 University Avenue

West Des Moines, IA 50266

515-225-5463

Fax 515-225-5661

NOMINATION INFORMATION: Be brief but list ALL of the nominee’s participation in Farm Bureau activities, leadership qualities and specific achievements.

NOMINATION INFORMATION: Be brief but list ALL of the nominee’s participation in agricultural activities, leadership qualities and specific achievements.

Please use space below for additional Nomination Information if needed. Indicate if it is Farm Bureau or agricultural activities.