2019 Louisiana/Mississippi Area Council Awards

Deadline for submission is 5 pm on Friday, July 26, 2019.

Contact Shakira Harris, sharris@bgca.org, with any questions about this application form.

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* 1. Nominee Name:

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* 2. Nominee Title:

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* 3. Boys & Girls Club Name:

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* 4. Years in the Movement

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* 5. Nominator Name:

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* 6. Nominator Title:

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* 7. Nominator Phone Number:

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* 8. Nominator Email:

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* 9. Committee Service: List committees and/or other functions the nominee has held (i.e. Professional Advisory Committee, Youth Development Committee, etc.) and the dates served.

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* 10. Impact on Club Members: Please describe how the nominee's actions have helped to improve the impact of Club programs in the past 12 months (i.e. recruited new community partners, serving new communities, in-kind supplies and equipment, etc.)

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* 11. Accomplishments: List the accomplishments of the nominee (for the past year) and describe why you feel this individual should be chosen as the Professional of the Year.

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* 12. Supporting Documentation

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