Governor's Community Service Award
Nomination Form

Open to High School Juniors and Seniors

Criteria for Selection:

• The individual has displayed a dedicated commitment to serving his or her community.

• The individual has volunteered his or her time to help those in need at a nonprofit, community organization, faith- based organization, business, school or national service program
• The individual has consistently put the needs of others above his or her own.

• The individual has set themselves apart from his or her peers through service.

My Name *
Your answer
My E-Mail *
Your answer
Nominee Name *
Your answer
Nominee E-Mail
Your answer
Nominee Phone
Your answer
Nominee School *
Your answer
Nominee School District
Your answer
Nominee Year *
Reason for Nomination *
Your answer
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