Clarence and Lilly Pickett Endowment for Quaker Leadership

Nomination Form

Mission

History of Pickett Fund

About Clarence Pickett

Trustees

Past Grantees

Guidelines & Expectations

Nomination Form

Application Form

This commemorative fund supports the development of Quaker leadership. Inspired by the Picketts' example and rooted in historic Quaker values, we seek to fund hands-on service projects that are directly related to the betterment of humankind.

Nominations are currently being accepted for the 2009 awards. Nominations must be received by January 01 to be considered.

Nominee Information

First Name

Last Name

Street Address

City

State --Choose A State-- Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming

Zip Code

Email

Phone

Monthly Meeting Affiliation

Why has this person attracted your attention?

Maximum of 250 words

How would a Pickett Fund grant help this person realize his/her leadership potential?

Maximum of 250 words

The information given above can be shared with the nominee?

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Nominator's Information

Nominator's Name

Nominator's Street Address

Nominator's City

Nominator's State --Choose A State-- Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming

Nominator's Zip

Nominator's Phone

Nominator's Email