Michelle Briggs "We're Here for Good" Service Award Nomination Form
The Avedis Foundation wants to recognize outstanding community volunteers in our service area. Nomination forms are due by December 31, 2021.

Nomination Criteria:
Persons being nominated for this award will have consistently demonstrated qualities of the Avedis Foundation Core Values. (Compassion, Humility, Innovation, Collaboration and Stewardship)

The nominees shall demonstrate, through their civic involvement, how the health and/or quality of life in their community has been enhanced through their volunteerism.

Eligibility: Any person that has provided exemplary community service in Pottawatomie County, Chandler, Meeker, Prague, Little Axe, or Seminole.

“Avedis Foundation supports public agencies, educational institutions, municipalities and other not-for-profit organizations. Organizations must be within Pottawatomie County or the surrounding communities of Seminole, Meeker, Chandler, Prague, and Little Axe.”

Selection will be based on the Nomination Form. Please do not advocate to Avedis Foundation Board Members or staff.

Example of Activities:
1. Initiating a community project;
2. Serving as an inspiration to others through continued commitment to our community;

The award will be presented during the Avedis Speaker Series Luncheon February 23, 2022.
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Email *
Name of Individual Being Nominated: *
Contact Phone Number for Individual Being Nominated: *
Volunteer Organization(s) for Individual Being Nominated: *
City/Town/Community Where Nominee Volunteered: *
Employer (if applicable) of Individual Being Nominated:
Email Address of Individual Being Nominated:
Nomination Form Submitted by (your name): *
Your Contact Phone Number: *
Your Email Address: *
Please detail the degree to which the nominee’s services/actions have made a lasting and/or meaningful contribution and/or impact on the health and/or quality of life for people within their community. The extent to which their service or action might be considered above and beyond the call of duty. *
Please detail how the nominee’s ongoing community service incorporates the Core Values of the Avedis Foundation. (Compassion, Humility, Innovation, Collaboration, and Stewardship) *
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A demonstration of how the initiative touched the health and/or quality of life of a person(s) in the community. The nomination must demonstrate the nominees ongoing community service, which may incorporate one of the below characteristics. If applicable, please describe how the nominee has met the characteristic(s) that exemplify their service to the community. *
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How long has the nominee been completing their community service? *
Other information that helps to illustrate the nature of their community service. *
A copy of your responses will be emailed to the address you provided.
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