Black Hills Volunteer of the Month Nomination
Volunteer of the Month is an area-wide award program sponsored by the Helpline Center and Black Hills Urgent Care in Rapid City. We are currently accepting nominations for the June 2021 through October 2022 cycle.
Nominee Name
*
First Name
Last Name
Pronunciation of Nominees First and Last name
Nominee Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nominee Phone Number
-
Area Code
Phone Number
Nominee Email Address
example@example.com
Nominee's T-Shirt Size
*
Small
Medium
Large
X-Large
2XL
Nominating Agency
Person Submitting Nomination
*
Nominator Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nominator Phone Number
*
-
Area Code
Phone Number
Nominator Email Address
*
example@example.com
Please answer the following questions in 500 words or less.
What volunteer activities did the nominee perform?
How long has the volunteer been serving and how often do they volunteer?
Why should this person win a Volunteer of the Month Award?
Is there additional information you would like to share?
Please provide information for the best person to contact for gift ideas for the volunteer (can include Volunteer Coordinator, family member, friend, boss, etc.)
*This information will be used to coordinate a gift purchase should this volunteer be chosen*
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Submit
Should be Empty: