LEADER AWARD NOMINATION FORM	2017

Please check one line below and use a separate form for each volunteer being nominated.

_____ Distinguished Service Volunteer Award (Nominate registered 4-H leaders with over 20 years of service)

_____ Salute to Excellence Volunteer Award (Nominate registered 4-H leaders with 11 - 20 years of service)

_____ Volunteer of the Year Award (Nominate registered 4-H leaders with 3-10 years of service)

(Volunteers may receive each award once; some awardees may be forwarded for further state recognition depending on award programs and more support/letters of recommendation/details may be requested.)

Nominee’s Name ___________________________________________________________________

Years as 4-H Leader __________ Club Name / County Leader ______________________________

Nominated by _______________________________________________(individual or 4-H Club)

Please tell us about the projects or activities this person has been a leader for:

Highlight contributions to 4-H program/impact on youth. This may be either on club, county, or state level.

Any additional comments your club may like to add.