Still Spirit Award Nomination Form

Still Spirit Award Nomination Form 2012

Honoring Those Who Make a Difference

Please cite your association/relation to the nominee and provide a required statement of support for each nominee.

The Statement of Support should include, but is not limited to:

Attributes/Characteristics – specific attributes/characteristics describing this candidate
Contribution – the scope of the individual’s volunteer work and how efforts have improved the quality of life for the community
Leadership – aspects of leadership may include ability to motivate and direct the efforts of others, articulate a service-related vision for the community, or formulate and implement ideas and activities that have a significant benefit to the community
Influence – the degree to which the individual’s efforts have influenced the community and fellow volunteers
Length of service – the length of time the individual has been involved in volunteerism

Nominations must be received by ATSU prior to 5 p.m., Friday, March 23, 2012, to be eligible for consideration. P rior Still Spirit Award recipients are not eligible for nomination.

*Required Fields

Still Spirit Award Nominee:

*Nominee's Name:

*Address:

*City:

*State: *Zip:

*Daytime Phone:

*Work and Service Affiliation(s):

*Please write your statement of support for this nominee:

Nominator:

*Your Name:

Work Address:

Work City:

State: Zip:

*Work Phone:

Fax:

Home Address:

Home City:

State: Zip:

*Home Phone(s):

Fax:

*Email Address:

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