Governor & First Lady’s Medals for Service Online Nomination Form

Nomination Form

** If you have not reviewed the special online submission instructions, please take a minute to review the instructions prior to completing the online nomination form. Please note that all fields are required, unless noted otherwise. **

 

To begin the online nomination process, please select the category for your nomination:

California’s Volunteer of the Year
Honoring an outstanding Californian whose volunteer service is exemplary and inspirational

California’s Small Business* Volunteer Program of the Year
Honoring an outstanding California small business with an innovative, high-impact employee volunteer program
* A California small business is defined as having less than 500 employees and operating for profit in California

California’s Business Volunteer* Program of the Year
Honoring an outstanding California business with an innovative, high-impact employee volunteer program
* A California business is defined as having more than 500 employees and operating for profit in California

California’s Nonprofit of the Year
Honoring a California nonprofit that has shown an extraordinary ability to leverage volunteers in service to their organization

California’s Service Group of the Year
Honoring a California service group / club with a demonstrable impact and unwavering commitment to their community

California’s AmeriCorps Member of the Year
Honoring a California AmeriCorps member who has demonstrated AmeriCorps values, has made a significant contribution to their community, and is committed to a lifetime of service

 

Please tell us about the nominee:

First Name:
Last Name:
Company/Organization:
(not required for individual nominees)
Address:
City:
Zip Code:
Phone:
Email Address:
Website:
(not required for individual nominees)

 

Please elaborate on your nominee by drafting a 1,500 word (maximum) essay and electronically attaching it (see below). Each of the following sections will be weighed equally. Please highlight each of the following:

  • A description of the nominee’s volunteer activity / service / program
  • How the activity / service / program addresses a critical community need and met or exceeded measurable outcomes
  • How the nominee collaborated with others, leveraged community resources and/or employed a unique approach to solving problems
  • How or why the nominee became engaged in service and volunteering and how the nominee is inspiring others to become engaged
  • How the nominee’s service reflects a dedicated and sustained commitment of time and effort
Attach Nomination Essay:  

 

A Letter of Support from somebody other than the nominator is also required as part of this nomination. Please attach a letter of support below.

Attach Letter of Support:  

 

Additional materials may also be attached to this nomination, although it is not required. This can include additional information or letters of support, photos, testimonials, news clippings, pamphlets, etc. PDF attachments are preferred; Word document attachments are acceptable.

Attach Additional Materials:  
Attach Additional Materials:  
Attach Additional Materials:  

NOTE: Electronic materials (video, CD, etc.) are acceptable and should be included as part of a mail-in nomination. Electronic materials should be no longer than 5 minutes in length. Any additional materials not initially included here should be emailed to recognition@CaliforniaVolunteers.ca.gov. The subject line of the email should read: “Additional Materials: (Nominee Name)”.

 

Please tell us about yourself:

First Name:
Last Name:
Address:
City:
Zip Code:
Phone:
Email Address:
 
Please tell us about your relationship to the nominee:
  Self
  Family member
  Friend
  Co-worker
  Employer
  Other

 

After completing all fields (unless noted) and attaching the appropriate documentation, you are now ready to submit your nomination. Please be sure to double-check that all required fields are completely filled out. Please click SUBMIT only once. The loading of the attachments may take a few minutes so please be patient. Clicking on SUBMIT more than once may cause an error.

 

 

REMINDERS:
Please remember that nominations for the 2nd Annual Governor and First Lady’s Medals for Service must be received by CaliforniaVolunteers by 5:00pm Wednesday, March 31.

Online nominations are strongly encouraged and should be submitted via this form. Mail-in nominations are acceptable and can be mailed to:

CaliforniaVolunteers
Governor and First Lady’s Medals for Service Nominations
1110 K Street
Sacramento, CA 95814

To review the official rules and guidelines, please see the document below:

Official Rules & Guidelines page

Please forward any questions to recognition@CaliforniaVolunteers.ca.gov.