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9 Who Care

Please remember our 9 Who Care Jefferson Awards panel of judges votes for your nominee based entirely on the information you provide. Please let us see a clear image of your nominee through your writing. Use as much space as needed!

1.Nominee's Name:

first*

last*

2.Nominee's Address:

address*

city, state, zip*

3.Phone #:

daytime*

evening*

4.Nominee's Occupation:

5.Your Name:

first*

last*

6.Your Address:

address*

city, state, zip*

7.Your Phone #:

daytime*

evening*

8.Your Email Address:

9.References: Please list the name & phone number of someone who knows the nominee personally, and the name and phone number of someone who knows the nominee through the volunteer activities.

Name 1:*

Daytime Phone 1:*

Evening Phone 1:

Name 2:*

Daytime Phone 2:*

Evening Phone 2:

10.Background Information: Please provide information on the nominee's personal life, such as family, education and interests.*

11.Honors & Awards: List nominee's past awards and recognition.*

12.Volunteer Activities: Please list all of the nominee's volunteer activities, length of service and any accomplishments. List only work for which there was no compensation.*

13.Outstanding Qualities: Please use this section to describe your volunteer. Give specific examples of they ways he or she cares.*

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