Volunteer Recognition Application Form

AN N U AL
VOLUNTEER RECOGNITION
AW AR D S
REGISTRATION DEADLINE:
Thursday, March 26, 2015
The Town of Quispamsis annually recognizes the important contribution that our volunteers make through many
organizations. Quispamsis residents, community groups, schools and churches are encouraged to nominate an outstanding
volunteer from their organization for the 2015 Volunteer Recognition Award.
These volunteers will be invited by the Mayor and Council to attend a special
presentation in their honour. At the presentation, which will precede a Council
meeting on April 21st, each of the volunteers will be presented with a
certificate and small token of appreciation from the Town.
Submissions will be received at the Town Hall until Thursday, March 26th.
For further information please contact
Megan Lucas at 849-5773 or [email protected]
2015 Nomination Instructions:



Nominees must be a resident of the Town of Quispamsis. Nominations are accepted from any not-for-profit
agency, community organization or school. Nominations will not be accepted for volunteer work in political
activities, parties, nor as a lobbyist.
Organizations may nominate only one volunteer.
The Town of Quispamsis assumes no responsibility for lost, delayed or misdirected applications.
Nominating Organization’s Name:_____________________________________________________________
Nominating Organization’s Contact Information:
Contact Person: _____________________________ Title: ___________________________________________
Full Mailing Address: __________________________________________________________________________
Telephone Number: _______________________
E-mail Address:_____________________________________
We/I nominate the following person:
Name: _____________________________________________________________________________________
Full Mailing Address: __________________________________________________________________________
Telephone Number:________________________ Email Address: ________________________________________
VOLUNTEER ACTIVITIES
1.
Give a brief history of the community service and volunteer work of the nominee .
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
2.
How has this volunteer gone above and beyond in your organization and/or community?
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
3.
Tell us a little about the characteristics of the person you are nominating and why you feel they are deserving of this award.
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
On behalf of _______________________________ (organization’s name) I hereby certify that, to the best of my knowledge, the above
information is true and complete.
_______________________________________
Signature
____________________________
Date