Form
Community Award Nomination
Award Selection
Please Select
Community Excellence Service Award
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Community Information
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
County
Phone Number
Please enter a valid phone number.
Email
example@example.com
Date of Birth
xx/xx/xxxx
Service Location(s) Information
Name of organizations
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Organization/Community
Served
Organization/Community
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
County
Phone Number
Please enter a valid phone number.
Email
example@example.com
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Nominator Information
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
County
Phone Number
Please enter a valid phone number.
Email
example@example.com
Relationship to Community
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Narratives
Please answer the following questions in 400 words or less per answer
Volunteer activity(ies): What volunteer service did the organization provide? When was it provided? What community need did the volunteerism address? How many employees were involved in the service project?
Impact: What was the impact of the service project? How did the community/ organization benefit from the service project?
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