Download Community Service Award

Instructions to Nominators 1. Complete nomination form to the best of your ability. Feel free to nominate multiple individuals. 2. Keep in mind that the nomination is only as good as the information you provide to us. 3. If there is a question on the nomination form that does not apply to your nominee or if the answer is unknown, leave the question blank or respond with as much information as known. 4. Please provide a picture for the committee to include in a slideshow presentation for the Gala. Any questions regarding the nomination process should be directed to Dr. Marche Fleming-­‐
Randle at 316-­‐978-­‐6640 or marche.fleming-­‐[email protected]. *Please print clearly. Nominator’s Information Nominator’s Name: __________________________________________________________________________ Nominator’s Email: __________________________________________________________________________ Nominator’s Address: _______________________________________________________________________ _________________________________________________________________________________________________ Nominator’s Home/Cell Phone: ____________________________________________________________ Nominator’s Relationship to nominee:____________________________________________________ ________________________________________________________________________________________________ Nominee’s Information Nominee’s Name: ____________________________________________________________________________ Nominee’s Email: ____________________________________________________________________________ Nominee’s Home/Cell Phone: ______________________________________________________________ What award is the nominee being nominated for: Community Service Awards Criteria
Social Justice Award
• Has made a measurable impact on the community by addressing important social justice
issues locally, nationally, or internationally.
• Is a public servant to the Wichita community.
• Exhibits good character and something outstanding, unique, or heroic.
Legacy Award
• Has made a measurable impact for at least10 years by addressing important issues facing
the local community.
• Is a public servant to the Wichita community.
• Exhibits good character and something outstanding, unique, or heroic.
Rising Star Award
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Exhibits a promising future as a public servant.
Has made a measurable impact for no more than 10 years by addressing important issues
facing the local community.
Exhibits good character and something outstanding, unique, or heroic.
*Feel free to include newspaper articles, pictures, or any other documents that will support your answers. Social Justice
1. Please explain how the nominee has a measurable impact on social justice issues
within the Wichita community.
2. Is there anything outstanding, unique, and heroic about the nominee and his or her
character?
3. In what ways has the nominee displayed acts of courage, vision, dedication and
tenacity?
4. Are there any other noteworthy accomplishments you would like the selection
committee to consider?
Rising Star
1. Please explain how the nominee has displayed acts of service and has exhibited
potential for becoming a community leader.
2. Is there anything outstanding, unique, and heroic about the nominee and his or her
character?
3. In what ways has the nominee displayed acts of courage, vision, dedication and
tenacity?
4. Are there any other noteworthy accomplishments you would like the selection
committee to consider?
Legend Award
1. Please explain how the nominee has displayed consistent acts of service in the
Wichita community.
2. For how long has the nominee had a measurable impact on the community?
3. Is there anything outstanding, unique, and heroic about the nominee and his or her
character?
4. In what ways has the nominee displayed acts of courage, vision, dedication and
tenacity?
5. Are there any other noteworthy accomplishments you would like the selection
committee to consider?