X
X
PLEASE TELL US ABOUT YOURSELF:
*
First and Last Name:
Phone Number (xxx) xxx-xxx:
*
Email:
*
Relationship to Nominee:
Selection Criteria:
1. ...has contributed an unusual amount of time (hours per week and/or years) volunteering in the Topeka community.
2. ...is a role model and/or mentor who has made exceptional contributions to a volunteer agency or community.
3. ...has created an awareness of his or her project and/or has created an impact through volunteer activities.
Deadline for nomination(s) form to be submitted is April 1st 2016.
If you have questions, please contact Shana Hubbell, at leadershipjltopeka@gmail.com
Please complete this application as thoroughly as possible. Thank you!
PLEASE TELL US ABOUT YOUR NOMINEE:
*
First and Last Name:
*
Address, City, State, Zipcode:
*
Phone Number (xxx) xxx-xxx:
Email (if applicable):
*
Please list current volunteer position(s) and affiliations:
*
Why do you feel this individual (or group) is deserving of the JLT Community Volunteer Award?
Go Back
