Nomination for National Awards

Nomination for National Awards

Deadline for Submitting: February 15th of each year
Please check the appropriate award:
Nominee Name

First NameLast Name
Nominee Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Nominee Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Nominee Email
example@example.com
Service Unit Name
Cluster Name
Position for which nominee is being recognized
Girl Scout Position(s); NOTE: If nominee is a staff member, staff duties cannot be considered for this award.
1. What Girl Scout positions has the nominee held? Please include dates held.
What past Girl Scout positions has the nominee held? Please include dates held.
2. Has the nominee attended the appropriate training sessions for positions held?
3. Tell us about the service the nominee rendered and how it was beyond expectations of the position(s) held. Be specific, list the impact and results of this person's actions. And remember, staff duties may not be considered.
4. Who benefited from this service?

Other
5. List how this service impacted the Council and the results of this person's actions (include how service helped move Kentucky's Wilderness Road or GSUSA toward their goal and objectives.)
6. List other background, community roles, and services if relevant.
Nominated by

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Email
example@example.com

List below the individuals providing letters of endorsement:

Rows	Name	Phone Number	Email Address
Endorser 1
Endorser 2
Endorser 3
Endorser 4

Should be Empty: