Florida District Nomination ID:

2012-2013 A.C.E. Award Florida District Exchange Clubs Nomination Form

General Instructions: This nomination form should be completed by every A.C.E. Award
nominee who is competing at the club level. This form can be completed and submitted electronically or can be filled in by hand and sent via email to albert_marchant@hotmai.com or jhurstjr@bellsouth.net

Exchange Club of: Jacksonville, Florida Candidates Name: Home Address:

City: Home Phone: Cell Phone:

A.C.E. Award Chair: Albert Marchant and/or Dr. Jim Hurst Date of Birth:

State: School Name:

Zip Code:

We certify that the above-named student has participated in activities listed in this nomination and will graduate , 2013 from High School. ______________________
Signature of School Official

______________________
Signature of Parent/Guardian

______________________
Signature of Club President

Florida District Nomination ID:

2012-2013 A.C.E. Award Florida District Exchange Clubs Nomination Form

Candidates Name: Sponsoring Club: Jacksonville, Florida

Section 1: To be prepared by the candidates guidance counselor or principal to the sponsoring Exchange Club of Jacksonville Narrative (Not to exceed 500 words): Describe the obstacle this candidate has dealt with and how it was overcome, including implications for the future.

Florida District Nomination ID:

2012-2013 A.C.E. Award Florida District Exchange Clubs Nomination Form

Candidates Name: Sponsoring Club: Jacksonville, Florida

Section 2: To be prepared by the A.C.E. Award candidate: Narrative A (not to exceed 250 words): Describe in your own words the event or events in your life that you are most proud of.

Narrative B (not to exceed 250 words): Describe in your own words your plans for the future to make your community and world a better place to live.

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Remember: This nomination can be completed electronically and emailed to albert_marchant@hotmail.com or jhurstjr@bellsouth.net