Adult Award Nomination Form

About the Nominee
Name (as it should appear on the award)*

First NameLast Name
Please provide some additional information so we can identify your nominee. (We will not use this information to contact them, in case you want the award to be a surprise!)
Nominee's email
Nominee's phone number

Area CodePhone Number
Nominee's address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Troop Number
Service Unit*
Territory
Area Executive Email
example@example.com
Regional Executive Email
example@example.com
Does the person or group hold an official position with Girl Scouts of Greater Atlanta? If so, please list the position(s) below (for example, a Troop Leader, a Day Camp Director, a Cookie Manager, etc.).
Position for which the Volunteer is to be Recognized
(If you don't know, it's okay to leave this blank.)

Nomination Details
How has your nominee's service gone above and beyond the expectations for their position?*
The more details you can provide, the better.
Who benefited from the service provided? Please provide details like the number of girls/adults or grade levels and volunteer roles.*
Use your best guess if you are not sure of exact numbers.
What outcome(s) did the girls or adults experience?
What did the girls say they remembered or learned about their experience?
How has your nominee's service helped Girl Scouts of Greater Atlanta fulfill its mission and strategic goals?

Girls, adults, and/or parents are more involvedAn increase in funds raised to support the CouncilMore girls have been served by Girl ScoutsMore successful Product Programs for girls (Cookies or Treats & Keeps)The community has increased awareness of Girl ScoutsVolunteers are better prepared to serve girls
Please Elaborate

Shipping and Finish
Almost done! Please tell us where to send the award once it is approved:
Mail Award To:*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you planning a special ceremony to present this award? Let us know when so we can make sure you get your award in time.

(Please submit this form at least six weeks prior to the presentation date! The more complete and accurate your nomination is, the faster we can process it.)
Presentation Date*

MonthDayYear
How Will the Award be Presented?

Troop MeetingService Unit Meeting/ EventCluster or Regional Meeting/ EventOther
Now just give us your Girl Scout's Honor.*

I understand that the information submitted is sensitive and confidential in nature and should not be disclosed until council has approved the nomination.I certify that all statements made in this application are true and complete to the best of my knowledge.

About You