Appreciation Pin Award Nomination Application
The Appreciation Pin recognizes an individual’s exemplary service in support of delivering the Girl Scout Leadership Experience. Their service, which has had measurable impact on one geographic service area, helps reach and surpass the mission-delivery goals of the area. Nominations are accepted year-round and are reviewed by the committee on a rolling basis.
Award Requirements
The candidate is an active, registered adult Girl Scout.
The candidate abides by GSUSA and Girl Scouts River Valleys’ policies, standards and procedures.
The candidate actively recognizes, understands, and practices the values of inclusive behavior.
The service performed by the candidate is above and beyond the expectations for the position held, and has made an impact on a geographic area within the council’s jurisdiction.
Nomination Instructions
Complete the nomination application at any time. You will be asked to provide the date the award is needed. The nominations will be reviewed
within 30 days of the date indicated on the application
.
Note that if the candidate is approved for an award, they will receive a copy of the endorsement questionnaire responses.
Additional Adult Award descriptions are available at
GirlScoutsRV.org/Adult-Awards-And-Recognition
.
Candidate Information
Candidate Name
*
First Name
Last Name
Candidate Service Unit Name or Number
*
To look up service unit name and numbers, see our service unit directory.
Describe the volunteer position/role relevant to the nomination.
*
Candidate Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Candidate Phone Number
Please enter a valid phone number.
Candidate Email
*
example@example.com
Nominator Information
This is the designated contact person if candidate is awarded.
Nominator Name
*
First Name
Last Name
Nominator Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nominator Daytime Phone Number
*
Please enter a valid phone number.
Nominator Alternative Phone Number
Please enter a valid phone number.
Nominator Email
*
example@example.com
Nominator Position
*
Date award is needed by.
*
-
Month
-
Day
Year
Date Picker Icon
Appreciation Pin Endorsement Questionnaire
Please describe in detail how the candidate’s ongoing commitment, leadership, and service impacted the mission-delivery goals and priorities for the council and the Girl Scout Movement. Provide as much detail as possible to help the committee understand the exemplary nature of the candidate’s service.
Please describe the activity/activities this candidate implemented to support the delivery of the Girl Scout Leadership Experience.
*
When did the service work take place?
*
During the service period, how many girls and adults where enriched?
*
Please include roles and grade levels if applicable.
What were the goals and expectations? How did the candidate's service go above and beyond the expectations for the position?
*
Please provide specific examples.
How did the candidate demonstrate inclusive behavior?
*
Please provide specific examples.
Is there anything else you want to share about this candidate?
Please provide specific examples.
Submit
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