2016 United Way Volunteer of the Year Nomination Form

Thank you for considering a nomination for The United Way of Southwest Virginia Volunteer Center volunteer of the year. Please read the following information.

1) Nominee must be registered on the volunteer center website at www.volunteerswva.org.
2) Volunteer activities must have taken place within the United Way of Southwest Virginia service area.
3) Nomination form must be completed in its entirety.
4) Please provide as much detailed information as possible.
5) Submissions must be received by Friday, February 26, 2016.
6) The organization or individual that nominated the winners will be notified by Friday, March 4, 2016.
7) The winner MUST be able to attend the Awards Banquet on March 17, 2016.
8) The winner in each category will be nominated, by United Way, for the Virginia Governor's Volunteerism awards in December, 2016.

Question Title

* 1. Nominee's Information

Name: *

Company (N/A if not applicable):

Address: *

City/Town: *

State: *

ZIP: *

Email Address: *

Phone Number: *

Question Title

* 2. For which category are you nominating?

Education

Income

Health

Question Title

* 3. What service does the nominee provide within the organization for which they volunteer?
(Include the population served & approximate number of hours the nominee commits to the volunteer activity and any unique motivations regarding the willingness of the nominee to volunteer.)

Question Title

* 4. What achievements can be cited as the direct result of the nominee’s volunteer service to the community?
(Include specific measurable outcomes if possible. For example, improved conditions, services, or the lives of others in the community and state.)

Question Title

* 5. Does the nominee provide innovative approaches in their service?
(List results such as: building community support, generating resources, mobilizing additional volunteers, developing public/private sector partnerships, connecting communities and schools, encouraging civic engagement and responsibility, etc.)

Question Title

* 6. Has the nominee overcome any unique challenges or obstacles to perform this activity?

Question Title

* 7. Is there further information the judging panel should be aware of when evaluating the nominee?
(How long has the nominee been involved in community service?)

Question Title

* 8. Nominating Organization Information:

Representative Name:

Company (N/A if not applicable)

Address:

City/Town:

State:

ZIP:

Email Address:

Phone Number:

Question Title

* 1. Nominee's Information

Question Title

* 2. For which category are you nominating?

Question Title

* 3. What service does the nominee provide within the organization for which they volunteer? (Include the population served & approximate number of hours the nominee commits to the volunteer activity and any unique motivations regarding the willingness of the nominee to volunteer.)

Question Title

* 4. What achievements can be cited as the direct result of the nominee’s volunteer service to the community? (Include specific measurable outcomes if possible. For example, improved conditions, services, or the lives of others in the community and state.)

Question Title

Question Title

* 6. Has the nominee overcome any unique challenges or obstacles to perform this activity?

Question Title

* 7. Is there further information the judging panel should be aware of when evaluating the nominee? (How long has the nominee been involved in community service?)

Question Title

* 8. Nominating Organization Information:

* 3. What service does the nominee provide within the organization for which they volunteer?
(Include the population served & approximate number of hours the nominee commits to the volunteer activity and any unique motivations regarding the willingness of the nominee to volunteer.)

* 4. What achievements can be cited as the direct result of the nominee’s volunteer service to the community?
(Include specific measurable outcomes if possible. For example, improved conditions, services, or the lives of others in the community and state.)

* 7. Is there further information the judging panel should be aware of when evaluating the nominee?
(How long has the nominee been involved in community service?)