2022 Champions of Service Nomination Form

Please completely fill out this form to nominate a volunteer for the 2022 Champions of Service Award.  Volunteer nominees should demonstrate compassion and dedication, leadership and initiative, or innovation and creativity in addressing community challenges and serving others.

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* 1. Volunteer Name:

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* 2. Volunteer's Address

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* 3. City where Volunteer lives

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* 4. Zip Code

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* 5. Volunteer's Email

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* 6. Volunteer's Phone Number

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* 7. Nominated/Recommended by

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* 8. Organization or Business (if applicable)

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* 9. Nominator's Email

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* 10. Nominator's Phone Number

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* 11. Approximate number of hours served annually

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* 12. Nomination Type (select one)

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* 13. Region (select one)

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* 14. Please provide a description of the type(s) of volunteering/service the nominee is engaged in. (100 words max)

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* 15. Describe how the individual/group has demonstrated compassion and dedication, leadership and initiative, or innovation and creativity in addressing community challenges and service others. (500 words max)

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* 16. Please provide additional qualifying information, such as impactful stories, quotes from people served, and other detailed information on why this person deserves the Champions of Service award. (500 words max)

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* 17. How did you hear about this award?

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