Champions of Service Nomination Form

Please fill out this form to nominate a volunteer for the 2023 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. Organization (if applicable)

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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. Nominator's Email

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* 9. Nominator's Phone Number

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* 10. Approximate number of hours served annually (if available) 

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* 11. Nomination Type (select one)

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* 12. Region (select one)

Please complete the questions below. Your responses will be read by the award selection committee to determine this year's Champions of Service award recipients. Using complete sentences, details that describe the volunteer and their service, and stories about how their service has impacted others helps your application stand out.

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

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* 14. 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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* 15. This area is for optional additional 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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* 16. How did you hear about this award?

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