Jeff Garrett Community Service Award Nomination Form
Deadline: December 20

This is your opportunity to acknowledge outstanding professionals and community leaders within your organization or with whom you conduct business. The Jeff Garrett Community Service Award is designed to recognize an individual who exemplifies outstanding service to Jefferson County by their actions and contributions to the community outside the work place. Nominees must be members of the Chamber to qualify.

Judging Criteria:
A panel of judges will independently score each of the nominations based on their written application.

Qualifications:
- Individual has made major contributions to the quality of life in Jefferson County
- Individual is a resident of Jefferson County in good standing
- Individual has distinguished himself/herself through outstanding service to Jefferson County in one or more of the following areas: community service projects, youth work, civic club service, church activities, civic improvement projects, philanthropy, or economic development.
- Individual has a positive public image and strives toward professional accomplishment
- Individual has served the community outside the workplace
- Individual is not a previous Jeff Garrett Community Service Award recipient
- Individual is not a current elected political official
- Individual has exemplary public image favorable to chamber goals
- Individual has given extra effort to business issues
Please provide the following information about the person you are nominating:
Name of Nominee
Home Address
Work Address
Email & Phone Number
Please provide the following information about yourself:
Name of Sponsor
Home Address
Email & Phone Number
Relationship to nominee
Please answer the following questions about the person you are nominating.
Please list and describe the significant contributions that the nominee has made to their organization(s) including involvement, offices held, and period of time in each.
Please list examples of the nominee’s professional contributions.
Please list specific examples where the nominee has demonstrated leadership roles in community service and how his/her contributions have benefited the community.
Please provide a brief background of nominee’s work experience in Jefferson County.
Please provide a brief background of their family history (optional).
Please list any additional information you would like the selection committee to consider.
Please type your name and the date below, as a signature that the above information is accurate to the best of your knowledge.
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