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Leadership Awards Adult Nomination Form

1. NOMINEE INFORMATION:
Nominee Name:*
Home Phone:
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Cell Phone:
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Work Phone:
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E-mail:
Employer:
Title:
Tribal Affiliation:
Mailing Address:
Is the nominee aware of this nomination?
2. YOUR CONTACT INFORMATION:
Your Name:*
Your Home Phone:
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Your Cell Phone:
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Your Work Phone:
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Your Mailing Address:
Your E-mail:
3. What is your affiliation with the nominee?*
4. Please specify a nomination category:*

NOTE:

  1. For Volunteer Award please answer question 6, sections a through d only;
  2. For all other award categories, answer question 5, sections a through d only
  3. Helpful attachments include a Bio and/or a Resume.

5. Why do you believe this individual deserves to be recognized? Describe how this individual has demonstrated commitment to the American Indian Community.

Please be sure to address each of the following statements:

For Adult Nominees, describe how they have:

a.) How has the nominee assisted the American Indian community by developing or showing leadership in self or business? (maximum 2000 characters)
b.) How has the nominee demonstrated excellence, creativity and initiative in their business or profession with regards to and representing the American Indian community? (maximum 3000 characters)
c.) How has the nominee provided valuable service by devoting time and energy to improve the quality of life for others in the American Indian community? (maximum 5000 characters)
d.) Describe how the nominee has proved themselves as a leader among peers an in affecting positive change in their profession, workplace, and community. (maximum 3000 characters)

6. Why do you believe this individual deserves to be Volunteer of the Year? Describe how this individual has demonstrated commitment to the general community.

Please be sure to address each of the following statements:

a.) Explain how this volunteer’s work contributes to the welfare of the general community. What type of impact does their service provide? (maximum 3000 characters)
b.) List volunteer tasks, lengths and quality of service. (maximum 2000 characters)
c.) Explain the extent of commitment by discussing questions such as: What are the volunteer duties? How much responsibility do they hold? What leadership skills do they demonstrate? (maximum 5000 characters)
d.) Explain the extent of commitment by discussing questions such as: What are the volunteer duties? How much responsibility do they hold? What leadership skills do they demonstrate? maximum 5000 characters)
Please upload any additional files to support your nominee (ie., Resume, Bio, Letter of Recommendation)
NOTE: This is NOT required.
Upload file(s):