Living Legacy Nomination Form
Instructions:
As the nominator, please complete the nomination form and remind the endorsers to submit their forms separately. As the nominator, you may not also endorse the nominee. Forms will be reviewed upon receipt and you will be contacted if the form does not include the required material. Forms are due by February 15th of each year. Please provide a picture of the volunteer in his/her/they role if possible.
Criteria:
The Living Legacy Award recognizes a leader, co-leader, or leadership team that started a troop of kindergarten Daisies and continued with the same troop until the girls graduated as Ambassadors. The nominee is an active, registered Girl Scout adult, who is in good standing. The nominee has been in a leadership role with the same troop for the entire 13 years.
Name of person completing nomination form:
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
I have read and understand the criteria for this award:
Yes
Signature
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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Name of Nominee
Nominee Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nominee Phone
Nominee Email
Current position(s) held by nominee:
Nominee must be a currently registered member, is nominee a registered Girl Scout?
Yes
No
In the box below please state, in 400 words of fewer, your reasons for endorsing this nomination. We are looking for the impact this volunteer has had in mentoring girls from Daisy level to Ambassadors.
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Should be Empty: