Coffee County GVSA Nomination Form

GVSA Coffee County Nomination Form
The Governor's Volunteer Stars Awards (GVSA) is an annual event that honors the efforts of volunteers from across Tennessee. Each year one adult and one youth are selected to receive this prestigious award in recognition of their exemplary volunteer service in the county. The guidelines and application for this award is listed below.
COMPLETE ALL FIELDS MARKED WITH * FOR NOMINATION TO BE CONSIDERED.
First and Last Name of Nominee*
Date of Birth*

MonthDayYear
Date
Email Address*
example@example.com
Daytime Phone*
Format: (000) 000-0000.
Address*

Physical Address

Street Address Line 2

CityStateZipState / Province

Postal / Zip Code
Mailing Address (if different from physical)

Street Address Line 2

CityStateZipState / Province

Postal / Zip Code
Organization(s) Where Nominee Serves*
Organization Contact Name*
Organization Phone*
Format: (000) 000-0000.
Organization Email Address*
example@example.com
YesNo
Youth Volunteer age (not applicable for Adult Nominees age 26+)
Ifvolunteer is under the age of 19, please provide the legal guardian's information here:
Legal Guardian's Name
Email Address
example@example.com
Phone Number
Format: (000) 000-0000.
Full Legal Name of Nominator*
Company/Organization*
Daytime Phone*
Format: (000) 000-0000.
Other Phone
Format: (000) 000-0000.
Address*

Address

Street Address Line 2

CityStateZipState / Province

Postal / Zip Code
Email Address
example@example.com
Relationship to Nominee*
NewspaperWebsiteVolunteer ActivityFriendOther
III. Nomination Narrative - Explain why your nominee should be considered for a Governor's Volunteer Stars Award. The narrative must answer the following questions: 1. What organization(s) does the nominee serve with? 2. How long has the nominee completed volunteer activity with the organization(s)? 3. What type of service does the nominee perform? 4. What makes the nominee's volunteer service unique and/or creative? 5. What is the extent to which the nominee's service goes above the call of duty? 6. How does their service address or solve a local community need? 7. What is the degree to which their services/actions have made a lasting contribution or meaningful impact on their community? 8. What sets the nominee apart in terms of their character and/or commitment to the community? *
Limit narrative to 200 words or less
IV. Summarize Key Points - summarize the nominee's volunteer activities in 50-60 words. This should highlight what makes them a volunteer star. If your nominee is selected, this will be read at the GVSA Celebration as the honoree is recognized. Let Tennessee know why they're so amazing!*
Limit narrative to 60 words or less
V. Photographs - submit at least one photograph of the nominee. Feel free to include 1 or 2 additional photographs that reflects the nominee's service.*

Attach up to three photos
Cancelof
Should be Empty:

GVSA Coffee County Nomination Form