2025 Show Me Service Award Nomination Form
Missouri Community Service Commission
Nominator E-mail
example@example.com
Nominator Phone Number
-
Area Code
Phone Number
Nominee Name
*
First Name
Last Name
Nominee E-mail
example@example.com
Nominee Phone Number
-
Area Code
Phone Number
Nominee Address
Street, City, State, Zip
Nominee Region
Kansas City Area
St. Louis Area
North/Central MO
Southern Missouri
Please select the correct category for the nominee:
AmeriCorps Member of the Year: Presented to a person who served in either AmeriCorps State, National, NCCC, or VISTA in the past year.
AmeriCorps Senior Volunteer of the Year: Presented to a person who served in an AmeriCorps Seniors (Senior Corps) program in the past year.
Youth Volunteer of the Year: Presented to those under 18.
Adult Volunteer of the Year: Presented to those 18 to 54.
Senior Volunteer of the Year: Presented to those over 55.
Business of the Year: Presented to a for-profit business that has provided opportunities for its employees/volunteers to volunteer in the community.
Community of the Year: Presented to a community (municipality or county) that has come together on a specific service project or ongoing service activity.
Where is the AmeriCorps member/Senior volunteer serving?
Please list the AmeriCorps program/organization.
This nominee served approximately _________ hours during the last year.
Question 1: Name 3-5 measurable outcomes that are a result of the nominee's service. e.g. # of meals served.
*
Question 2: Provide 1-2 paragraphs describing the service the nominee performs, the difference they are making. Who do they impact? Why is it important?
*
Question 3: Provide a short quote and/or testimonial from a fellow volunteer, staff person, community member, etc.
Name Check: Confirm correct spelling of nominee's name and pronunciation.
Photo of Nominee: Please provide a good quality photo of the nominee. This will be used for a presentation.
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