Community Impact Award Volunteer Nomination

2011 Outstanding Volunteer of the Year
NOMINATION FORM

The value of volunteer manpower invested for the public good in East Texas cannot be
adequately measured. The value goes beyond dollars and cents, because they don’t just
give their time– they offer commitment, passion and sacrifice for the causes they serve.

Qualifications: The nominee exhibits an exceptional commitment to the people of
Angelina or Nacogdoches county and to advancing the quality of life here by volunteering
at the grass-roots level for a local non-profit entity (or entities), while demonstrating these
qualities:

    Sacrificial service to the non-profit organization(s)
    Favorable relationships with other volunteers
    Willingness to promote the non-profit organization he or she serves
    Practices integrity, is an excellent role model and has a good reputation

NOMINEE

Nominee's Address

Nominee's City, State, Zip

Nominee's Phone

Nominee's Email (if known)

NOMINATOR

Business/Organization Name (if applicable)

Address

City, St, Zip

Phone

Email

How did you hear about the Community Impact Awards?

Criteria: Provide the following information about the nomnee:

Describe in detail the nominee’s history of service at the local non-profit
organization(s) where he or she volunteers.

Describe the impact the nominee has had on the community through
volunteer service, including the sectors of the population for whom he or she has
provided benefit.

Briefly describe evidence of the following qualities in the nominee’s life:
a. An excellent role model for others
b. Integrity
c. A good reputation
d. Favorable relationships with other volunteers in the organization(s)

Describe how the nominee promotes the organization he or she serves to others.

INSTRUCTIONS AND POLICIES

Eligibility: Nominee must live or volunteer in Angelina or Nacogdoches county. Individuals or
immediate family members of individuals who are current board members or staff of KSWP and
KAVX, sponsors of the Awards, or committee members of the Award’s Host Committee or Selection
Committee are ineligible for nomination. Nominations will be open to more East Texas counties in
future years.

Completeness: Nominator must respond to each of the award criteria outlined on Page 1 in no
more than three pages. Submissions that fail to address each award criteria will not be considered.

Supplemental material: No supplemental material (newspaper articles, brochures, photos, etc.)
will be accepted with the nomination form.

I HAVE READ AND UNDERSTAND THE INSTRUCTIONS AND POLICIES OF THE NOMINATION PROCESS: YES

I am a person!

Winners will be honored at the KSWP/KAVX
Community Impact Awards Ceremony in the fall.

 

For more information or if you have questions, please call KSWP & KAVX at 800-944-8443
or contact Susan Robertson (susan@kavx.org) or Nila Bartley (nila@kswp.org).

The Community Impact Awards of East Texas are presented by
KSWP/KAVX/LEBF, a non-profit organization serving East Texas.

http://ciaetx.com/