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Volunteer of the Month
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Mayor's Volunteer of the Month Award Nomination Form
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This form has been modified since it was saved. Please review all fields before submitting.
Eligibility and Criteria for the Award
The Volunteer of the Month nominee should be committed to making the City of Marysville a better community through voluntary personal service to meet community needs. The nominee will be considered based on initiative and good work achieved through volunteer service. Nominations should be made for direct service, board service or administrative volunteering. Individuals may be nominated by an individual, agency, corporation, or organization. Nominees must be residents of Marysville.
Nominee Information
Please fill out information for the person you are nominating:
Nominee First Name (indicate Mr., Mrs, Ms.)
Nominee Last Name
Nominee Daytime Phone Number
Nominee Address 1
Nominee Address 2
Nominee City
Nominee State
Nominee Zip
Nominee Employer
Nominee Email Address
Age Classification
Please check the appropriate age classification for your nominee:
Youth (18 and under)
Young adult (19-25)
Adult
Senior (60 and over)
Verification
To qualify, a nominee must have one reference who may be contacted to verify the scope and extent of the nominee's activities. Reference should be a person familiar with teh community service activities for which the nomination is made and should not include either the nominee or any persons related to the nominee. The reference below must be someone other than the nominator.
Reference First Name
Reference Last Name
Reference Daytime Phone Number
Reference Address 1
Reference Address 2
Reference City
Reference State
Reference Zip
Reference Agency/Organization
Reference Email Address
Nominator First Name
Nominator Last Name
Nominator Address 1
Nominator Address 2
Nominator City
Nominator State
Nominator Zip
Nominator Agency/Organization
Nominator Email Address
Volunteer Activities
Please check the box that best fits the nominee's volunteer activities. Multiple boxes can be selected.
Parks
Business
Church
Special Needs
Education
Elderly
Health/Hospitals
Food Bank
Shelter/Housing
Neighborhood
Sports
Youth
Arts
Philanthropy
Miscellaneous
Tips for Completing the Nomination Form
Please use the next section to highlight how your nominee volunteers to serve our community. You are encouraged to interview your nominee or get a quote from them on their thoughts about volunteerism and giving back to the community. You can gain a deeper level of understanding about their service, reasons, motivation, and unique challenges or circumstances they face, or faced, when volunteering. Consider including information on the need for the service the nominee is delivering. Additionally you could include details if they started a new organization, are using new methods to solve problems, initiated activities, or built collaboration with other organizations.
Approximately how many hours does the nominee volunteer per month?
Describe the impact the nominee's service made to the community.
Overview of Nominee Volunteer Activity
Please use the section above to highlight how your nominee volunteers to serve our community. Please limit your comments to 300 words or less.
Additional Page
If more space is needed, one additional page can be uploaded to support the information you included above. Do not submit supplementary materials, such as news or magazine articles, awards or personal transcripts.
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