** 2017 Dewey Winburne Community Service Award Nomination

Dewey Winburne Community Service Awards Nominations 2017
This form is for nominations for the 2017 Dewey Award. Deadline for nominations is 11:59pm CT July 22, 2016. This community service award celebrates the life and work of SXSW Interactive co-founder, Dewey Winburne. Learn more about Dewey's life here.

Ten honorees will receive a $1,000 grant to an eligible 501(c)(3) or charitable equivalent of their choice and a complimentary registration to SXSW 2017.

The Dewey Award is intended to honor the contributions of individuals rather than organizations or groups. (For grants for Organizations, please see SXSW Community Fund Grants.)
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email*
Phone Number*

Area CodePhone Number
LinkedIn (or other online profile link)*
Please describe the nominee's ethnicity and / or race. This information is not required, and will be used for demographic purposes only. Please select all that apply.

American Indian or Alaska NativeAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or Other Pacific IslanderWhiteI don't knowI choose not to provide this information
Are you nominating yourself or someone else?*

MyselfSomeone Else
Nominee's Full Name*

First NameLast Name
Nominee's Email*
Nominee's Phone *

Area CodePhone Number
Nominee's LinkedIn (or other online profile link)*
Nominee's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Do you know the nominee?*
How long have you known the nominee?*
In what capacity do you know the nominee, i.e., how did you meet, what is the nature of your relationship, etc.?*

0/2500
Who is the best point of contact for the award notification?*

Me – I will inform the nominee of the selection, we are in frequent contact. I will explain that I have nominated them if they are chosen.The Nominee – I am simply nominating, the nominee should be contacted directly and is aware they were nominated.
Give a short explanation of how this person exemplifies community service. How has this person's work improved the community or enhanced the lives of its residents?*
What is inspiring, unusual or innovative about this person's work?*
Dewey Award honorees are recognized for their use of digital technology to help others. How does this person use technology to help others?*
Should be Empty:

Dewey Winburne Community Service Awards Nominations 2017