{other:date} {other:time}

Name of Person/Persons Being Nominated: (Nominee/Nominees)
{field:individual_or_group_name_1706636234814}

Address of Nominee(s) or Work Address:
{field:address_1706636312140}, {field:city_1706636322722}, {field:liststate_1706636323898} {field:zip_1706636324680}

Email for Nominee(s):
{field:email_1706636311084}

Best Phone # to Contact Nominee(s):
{field:phone_1706732554477}

Select One Volunteer Award Category:
{field:please_mark_one_1737125553548}

Note: Youth Volunteer Scholarship nominations are limited to high school seniors. Nominations can be made by the youth or others family, teachers, non-profit organizations). Youth nominees will be contacted to submit an essay on volunteerism to include with the nomination or, if self-nominated, will have submitted their essay with the nomination.

Describe the Volunteer Work of the Nominee(s):
Items to include:

Activity – What are the volunteer(s) responsibilities and services within the organization.
Need/Impact – Describe the need for these services and how the volunteer(s) have made a positive impact on the organization and/or the community.
Initiative – Did the volunteer(s) start a new program, initiate activities or promote collaboration?
Achievement - What results were accomplished through the volunteer(s) efforts?
Service – Describe or list other volunteer service, including service for other agencies, groups or organizations.

Describe the Volunteer Work of the Nominee(s):
{field:activity_need_impact_initiative_and_achievement_1706637229431}

Service / Other: Please include other volunteer service, groups or organizations membership, or information as deemed appropriate for nomination. If this nomination is for the Karl May Lifetime of Service Award, in your own words, please tell us why your nominee is most deserving of the Karl May Award.

{field:service_other_1706637243427}

Name of Person Completing this Nomination:
{field:firstname_1706636578191} {field:lastname_1706636582374}

Organization: (if applicable)
{field:organization_if_applicable_1706636617874}

Best Way to Contact You if We Have Questions:
{field:preferred_contact_method_1706636643859}

Phone:{field:phone_1706732618913}

Email:{field:email_1706636670280}

Golden Heart Award Nomination

We Fight For:

Need help?

Nomination Deadline is Tuesday, March 3, 2026

Give.

Advocate.

Volunteer.