2023 Area Council Award Application - Beverly Burton New Board Member of the Year

Contact DOD or Joe Ethier with any questions.

This award is given to a Board/Council member with less than three years of service on a local governing body.

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* 1. Please select your state:

Mississippi

Louisiana

Alabama

Florida

Georgia

South Carolina

North Carolina

Virginia / DC

Tennessee

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* 2. Date:

Date / Time

Date

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* 3. Nominee Name:

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* 4. Club Affiliation

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* 5. Length of Board Membership:

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* 6. Nominee Company

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* 7. Nominee Work Title:

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* 8. Nominator Name:

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* 9. Nominator Title:

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* 10. Board Participation: Select the person's attendance percentage of regular board meetings.

0 - 20%

20 - 30%

30 - 40%

40 - 50%

60 - 70%

70 - 80%

80 - 90%

90 - 100%

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* 11. Committee Service: The individual has served on the following committees (select all that apply)

Executive

Board Development

Resource Development / Finance

Human Resources

Marketing & Communications

Property Management

Safety

Program

Other (please specify)

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* 12. Leadership: List any offices held by the nominated individual. Include name of office and dates held.

Office 1:

Office 2:

Office 3:

Office 4:

Office 5:

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* 13. Resource Development: The individual is responsible for financial contributions to their Boys & Girls Club at the following level:

0 - $5,000

$5,001 - $10,000

$10,001 - $25,000

$25,000 - $50,000

$50,001 - $100,000

$100,001 - $200,00

Over $250,000

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* 14. Service to Area Council: The individual has served the Area Council in the following capacity (select all that apply)

Chair

Vice-chair

Secretary

Treasurer

Liaison

Committee Member

Committee Chair

Other (please specify)

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* 15. BGCA Education Training: The individual participated in the following (select all that apply)

Board Room Training

Area Council Annual Meeting

Board Leadership Conference

Regional Conference

National Conference

Presenter at Conferences

Board Roundtable Facilitator

Promotion and Marketing of Local Organization and/or BGCA

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* 16. Impact on Boys & Girls Club: Please describe the immediate impact of this individual's involvement with your Boys & Girls Club.

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* 17. Community Relations: Please list other service groups or agencies with which the nominee is involved. How have these affiliations helped your Boys & Girls Club?

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* 18. Additional Information: Please list any other pertinent information you would like to share concerning the nominee's Club service, awards received, personal or family information, college attended, etc.

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* 19. Supporting Documentation: Please upload any supporting documents here:

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File