Individual Nominations

*Required Information
Nominee Information
* School:
* School Name:
* Name:
* Address:
* City: * State: * Zip:
* Phone:
* Email:
Grade:
Number of Hours:
Age:
Organization Info
* Organization: (Name of organization for which they volunteer)
Organization Phone:
Contact Person:
Nominator Info
* Name:
* Address:
* City:
* State:
* Zip:
* Phone:
* Email:
Activity: Provide a detailed description of the volunteer service and the following:
Need: Describe need for nominee's service(s).
Time: Number of hours nominee has volunteered for organization.
Achievement: Did nominee accomplish desired results? Explain
Impact: Describe impact or difference nominee's service made to the community. How many people were affected?
Challenges: Did nominee overcome challenges (physical or mental handicaps, limited resources, public perception)?
Other: Why do you believe your nominee deserves the Service Above Self Award?
Please print a copy of the completed form for your records before clicking the submit button. Thank You.
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