HUMAN SERVICES ADVISORY COUNCIL, INC
P.O. Box 894 Council Bluffs, Iowa 51502
Email address *
Volunteer of the Year Award Nomination Form
Deadline: October 31st

Award Guidelines: This award recognizes a person demonstrating dedication and commitment through their volunteer efforts. The nominee must currently be providing volunteer services for your organization.
Nominee’s Name *
Your answer
Volunteer Role
Your answer
How long has the nominee volunteered for your agency/organization?
Your answer
How often does nominee volunteer each month?
Your answer
Does the nominee volunteer anywhere else in the community (service agencies, church, school, etc?)
Choose the Qualities this nominee possesses
Compassionate
Honest
Empathetic
Polite
Generous
Tactful
Efficient
Friendly
Humble
Organized
Dedicated
Helpful
Good listener
Trustworthy
Team player
Creative
Hard working
Willing to learn
Leader
Qualities
Explain why this nominee deserves to be recognized for his/her efforts. Include an example of how this volunteer stands out from other volunteers you’ve worked with. Please limit your response to two paragraphs.
Your answer
Nominator’s Name *
Your answer
Nominator's Position *
Your answer
Nominator's Agency/Organization *
Your answer
Nominator's Phone *
Your answer
Nominator's Cell
Your answer
Nominator's Email *
Your answer
* If your nominee is a finalist, you may be contacted to provide further information.
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