11th Annual Bethune Leadership Recognition Banquet Nominee Application

Congratulations Nominee!

The Valdosta-Lowndes Metropolitan Section of the National Council of Negro Women (NCNW) is excited to host its 11th Annual Bethune Leadership Recognition Program, honoring outstanding leaders in Valdosta-Lowndes County and surrounding communities.

This program celebrates individuals who exemplify continuous and dedicated service to their communities and organizations. Join us on Saturday, November 8th, 2025, as we honor excellence in leadership. NCNW, a community service “organization of organizations,” is dedicated to empowering families and communities through leadership, advocacy, and service.

To apply, please complete the form below. All applications must be submitted by Friday, August 29, 2025 at Midnight.

For questions, contact: ncnwofvaldosta@gmail.com.

Instructions

Fill out all required sections of the application.
Upload a professional headshot and two letters of reference.
Include a personal statement describing your leadership journey and community impact.
Submit the completed application by the deadline.

Nominee Information

First name

Last name

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Nomination Details

What Level Nomination Are You Applying For?:

Community (For individuals actively serving the community)

Collegiate (For college students)

High School

Parent/Guardian (High School/Collegiate Students)

Required for High School nominees only.

Escort's Name (Optional)

Nominees requiring an escort must submit a $50 payment to cover escort arrangements.

Supporting Documents

Upload a Headshot

Upload a high-resolution headshot.

Upload Two Letters of Reference

Upload two (2) letters of reference.

Achievements and Involvement

School and/or Grade (if applicable):

For High School and Collegiate nominees

Highlight Your Most Significant Achievement:

Describe your most significant professional, academic, or career accomplishments

Community Service, School Activities, Volunteerism, and Involvement:

Include details about community service, school activities, volunteerism, and leadership roles.

Honors and Awards:

Provide a list of any honors, recognitions, or awards you have received.

Other Interests or Talents:

Share additional information about your interests, hobbies, or unique talents.

Personal Statement

Tell Us About Your Leadership Journey and Community Impact

Write a statement about your leadership journey, contributions, and how this recognition aligns with your values.

Acknowledgment and Signature

Signature

Signature field is empty.

By signing, I affirm that the information provided is accurate and truthful to the best of my knowledge.