Nominator’s Company/Organization:

Nominator’s Mailing Address:

Nominator’s Preferred Contact Number:

Nominator's Email:

Name of Nominee:

Nominee's Company/Organization:

Nominee's Mailing Address:

Nominee's Preferred Contact Number:

Nominee's Email:

Does the nominee live or work in Stark or Carroll County?
YesNo

Is the nominee 45 years of age or younger?
YesNo

How do you know the nominee:
(Feel free to share comments about the individual’s character and attributes.) Limit 500 words

Please describe how the work or volunteer activity has had an impact on the quality of life in our community, specifically with the established United Way of Greater Stark County’s focus on families with children ages 0-8, who are living in poverty in our community:


Please describe the nominee’s volunteer efforts toward helping children and families living in poverty in Stark County – with emphasis placed on community
volunteer involvement. Limit 500 words.

Describe how, when and why the activity or work began:

Please list any service projects and/or volunteer activity:
List and briefly describe hands-on service projects that the nominee has completed in the past five years. Which project is he/she most proud of and why? Was the project volunteer or work related? Limit 500 words.

Please list any leadership activities, memberships on board(s), committee(s), service awards & honors:

Feel free to share any other thoughts on how the nominee chooses to to support programs or services that help families with children living in poverty in our community.:

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