Mayor's Volunteer of the Month Award Nomination Form

2. 

4. 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.

   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.

8. Nominee Information
   Please fill out information for the person you are nominating:

   Please fill out information for the person you are nominating:

10. Nominee First Name (indicate Mr., Mrs, Ms.)

11. Nominee Last Name

13. Nominee Daytime Phone Number

15. Nominee Address 1

17. Nominee Address 2

19. Nominee City

20. Nominee State

21. Nominee Zip

23. Nominee Employer

25. Nominee Email Address

29. Age Classification

    Please check the appropriate age classification for your nominee:

    1. Youth (18 and under)

    1. Young adult (19-25)

    1. Adult

    1. Senior (60 and over)
33. 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.

    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.

35. Reference First Name

36. Reference Last Name

38. Reference Daytime Phone Number

40. Reference Address 1

42. Reference Address 2

44. Reference City

45. Reference State

46. Reference Zip

48. Reference Agency/Organization

50. Reference Email Address

52. Nominator First Name

53. Nominator Last Name

55. Nominator Address 1

57. Nominator Address 2

59. Nominator City

60. Nominator State

61. Nominator Zip

63. Nominator Agency/Organization

65. Nominator Email Address

69. Volunteer Activities

    Please check the box that best fits the nominee's volunteer activities. Multiple boxes can be selected.

    1. Parks
    2. Business
    3. Church
    4. Special Needs

    1. Education
    2. Elderly
    3. Health/Hospitals
    4. Food Bank

    1. Shelter/Housing
    2. Neighborhood
    3. Sports
    4. Youth

    1. Arts
    2. Philanthropy
    3. Miscellaneous
73. 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.

    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.

75. Approximately how many hours does the nominee volunteer per month?

77. Describe the impact the nominee's service made to the community.

79. 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.

81. 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.

Leave This Blank:


85. 1. Receive an email copy of this form.
86. Email address

    This field is not part of the form submission.

87. Submit

* indicates a required field