CORE Champions Award Nomination Form
Commit ~ Optimize ~ Reinvest ~ Equip
Please indicate the award (one only) for which you are submitting a nominee for consideration:
___ Outstanding Young Alumni ____ Outstanding Patron Award
___ Distinguished Alumni ____ Distinguished Service
Please attach the following documentation for nominees listed in either award category:
-
Resume
-
Additional substantiating information if available (web links or web pages, etc.)
-
Letters of support from others (at least 1; no more than 3)
Nominee: __________________________________ Phone: _________________
Address: __________________________________________________________
City: ____________________________ State: ______ Zip: ___________
Email Address: ______________________________________________________
If nominee has a website, please provide URL: _________________________________
If the following information is included on the nominee’s attached resume, or referenced within addition substantiating information (web links, web pages, etc.), you do not need to copy that information into the spaces provided below and on the pages that follow.
Education: _________________________________________________________
_________________________________________________________________
Current Professional Position: ___________________________________________
Professional Credentials: _______________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Community Involvement: _______________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Recognition (Local, State, National Levels): ___________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Career Contributions – Outstanding or distinguished contributions to their professions or chosen fields of endeavor or for distinguished human service to their community: ________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
What makes this individual exemplary – what makes him/her a “Champion” who is more noteworthy than other individuals in a similar position?
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Complete this section for Distinguished Service Award or Outstanding Patron nominees only:
How has this business or individual shown exemplary service to Greeneville City Schools through involvement with students, volunteer service, or financial support?
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
ALL SUPPORTING DOCUMENTATION MUST ACCOMPANY COMPLETED NOMINATION FORM. Deliver GCS Education Foundation, Attn.: Amanda Waddell, 129 W. Depot Street, Greeneville TN, by January 8th, 2015 – or mail to P.O. Box 1420, Greeneville, TN 37744-1420. Mailed entries must be postmarked no later than January 4th, 2015. For more information, contact Amanda Waddell, 423-823-8001.
Nominator Information
Name (print): ____________________________________ Date: ______________
Email: _________________________________________ Phone: _____________
|