Agency Name Agency Address Agency Phone Agency Website Nominator Name Nominator Title Nominator Email Address Volunteer Name Volunteer Age Range - Select - 5-17 18-24 25-49 50-65 65 + Volunteer Mailing Address How many hours does this person volunteer per week? How many hours has this person volunteered in the past year? How has this person helped your organization? Explain why this nominee deserves special recognition. Does this person volunteer at other non-profits? If so, which organizations are you aware of? Additional Information Photo CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit