Distinguished Voluntary Service

2. Name, team or group of nominee*
4. Full address of nominee*
6. Phone # of nominee*
7. Email of nominee
9. Nomination is for:
   -- Select One --A specific eventContinuous service
10. Date and location of achievement (if applicable)
12. Describe why this nominee deserves this award:*
14. Additional documents
    Additional documents may be attached to complete your submission. The Selection Committee reserves the right to assign a nomination to an alternate category, provided the nominator agrees to the reassignment.
16. Upload additional documents
18. Name of nominator *
20. Full address of nominator *
22. Phone # of nominator *
23. Email of nominator
25. Signature of nominator *
    Type your name in lieu of signature.
27. Name of seconder*
29. Full address of seconder *
31. Phone # of seconder*
32. Email of seconder
34. Signature of seconder*
    Type your name in lieu of signature.
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36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field