Lloyd W. Jones Scholarship
Nomination Form

Nominee (must be State or local government employee)

Name:
Last: First: M.I.
Title: Years Employed:
Employer:
Address 1:
Address 2:
City: State: Zip Code:
Business Phone: E-mail:

Nominated By (must be MDGFOA Active Member)

Name:
Last: First: M.I.
Title: Years Employed:
Employer:
Address 1:
Address 2:
City: State: Zip Code:
Business Phone: E-mail:

Basis for Nomination:

Nominations may be submitted online or mailed by April 14, 2006 to:

Maryland GFOA Headquarters
9901 Business Parkway, Suite J
Lanham, MD 20706