*1.Nominee Information(Required.)

Name *

Organization *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Country *

Email Address *

Phone Number *

*2.Nomination submitted by:(Required.)

Name *

Organization *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Country *

Email Address *

Phone Number *

*3.Nomination Category (check those that apply to this nomination)(Required.)

Volunteer of the Year (may present multiple awards to recognize service in different types/categories of volunteer service across the state) - A volunteer who has made significant contributions to Wisconsin over the course of the year, through their service at a nonprofit , tribal entity, faith-based institution, school, or governmental agencies.  
Please identify which categories of volunteer service the nominee has done in the following question.

AmeriCorps Member of the Year - An AmeriCorps member who who has made significant contributions to Wisconsin over the course of the year through their service efforts with AmeriCorps or AmeriCorps VISTA.

AmeriCorps Program of the Year - An AmeriCorps program that has made significant contributions to Wisconsin over the course of the year through their service efforts.
Programs that received this award in 2022, 2023, 2024, or 2025 are not eligible to receive the award.

AmeriCorps Alumni of the Year - A former AmeriCorps member (State, National, VISTA, or NCCC) who has made significant contributions to the state of Wisconsin in the years following the conclusion of their term of service with AmeriCorps.
To be eligible for this award, AmeriCorps Alumni nominees must have completed their most recent term of service before September 1, 2021.

AmeriCorps Seniors Volunteer of the Year - An AmeriCorps Seniors volunteer who has made significant contributions to Wisconsin over the course of the year through their service efforts and using their invaluable skills and experience.

AmeriCorps Seniors Lifetime Impact Volunteer - An AmeriCorps Seniors volunteer who has made significant contributions to Wisconsin through at least 15 years of volunteer service (as of May 31, 2026) through AmeriCorps Seniors.

AmeriCorps Seniors Program of the Year - An AmeriCorps Seniors program that has made significant contributions to Wisconsin over the course of the year through their service efforts.
Programs that received this award in 2022, 2023, 2024, or 2025 are not eligible to receive the award.

Marty Stein Friend of National Service Exemplary Supporter - An exemplary supporter – individual or organization – of a national service program in Wisconsin, whether that support is monetary, in-kind, or volunteer time. The late Mr. Stein was the first President of the Serve Wisconsin Board.

4.Categories of Volunteer of Service (Volunteer of the Year): Please indicate one or more categories for which you would nominate the individual for their service. If making a nomination for an award other than Volunteer of the Year, please select Not Applicable to Nomination.

Animals

Arts / Culture / Community Events

Conservation / Environment

Disaster Response / Emergency Response

Economic Security (food, housing, resources, etc.)

Education

Medical / Health / Wellness

Nonprofit Support

Veterans

Youth Volunteer

Not Applicable to Nomination

Other (please specify)

*5.RESPONDING TO COMMUNITY NEEDS (not scored – background information only)

Describe the community needs that the nominee addressed through their service (100 words or less)(Required.)

SCORED PROMPTS (Four prompts - 25% of total score each)
Describe how the nominee has demonstrated excellence in the performance of their service and how the service provided by the nominee has impacted recipients, the community, and/or their organization in meaningful ways. Each prompt should be answered in 300 words or less

*6.PROMPT 1 - How does the nominee bring an outstanding passion or commitment to making a difference to their service and/or how did the nominee overcome personal, logistical, systemic, or other unique challenges to perform their service?   (300 words or less)(Required.)

*7.PROMPT 2 - How did the nominee create new or use exemplary approaches in performing/structuring their service and/or go above and beyond the requirements and expectations of their role/position while performing their service?  (300 words or less)(Required.)

*8.PROMPT 3 - What specific or measurable results demonstrate the impact of the service done by the nominee and/or how did the nominee meet community needs through their service?   (300 words or less)(Required.)

*9.PROMPT 4 - What stories/anecdotes demonstrate the qualitative impact of the service done by the nominee and/or what is different/changed as a result of their service?   (300 words or less)(Required.)

10.SUPPORTING MATERIALS
Put any links or descriptive information about any/all files uploaded here.  Options to upload files are below the box.

• Supporting materials (letters of support, news clippings, photographs, brochures, video links, etc.) are permitted for providing additional detail and support, but are limited to five (5) pages of text and ten (10) images
• Supporting materials are not required and there is no expectation of them being extensive (simply providing caps on these submissions)
• Please submit supporting materials as either a Word document, PDF, or shared Google Doc, with images shared either as a JPEG, PNG, or GIF, combined into a single document, or through Google Drive. 

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