LEADER OF THE YEAR NOMINATION APPLICATION

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LEADER OF THE YEAR NOMINATION APPLICATION The Leader of the Year is presented to someone who has served as an exemplary role model for girls, demonstrating the Girl Scout Promise and Law and EPIC. Award Requirements The nominee is a registered Girl Scout adult volunteer. Service given benefits at least one Troop within Council jurisdiction. Minimum of five continuous years as Troop Leader. Has served as an exemplary role model for girls in demonstrating the Girl Scout Promise and Law and EPIC. Nomination by the girls and/or parents of the Troop. Six endorsement letters, three of which are from the parents of the Troop. Retention and/or growth of Troop membership. Completion of all required training for position. Participation in Council and/or Service Unit events. Financial reports submitted on time of all five years. Additional service has been performed above Troop Leadership (such as SU Team position, hosted SU event, or served on a Council Committee). Only one Leader of the Year presented each year. Nomination Instructions Complete the required nomination application. These can be submitted by the same person or by different people as long as the nominator/endorser is familiar with the nominee s volunteer service. You can submit the completed nomination application at any time. The nomination application will be reviewed by the nomination committee in November 2017. Incomplete nomination applications may result in disqualification of the nomination.

NOMINEE INFORMATION Name: Service Unit: Troop Number: Address: City: Zip: Phone :( ) Email: Number of Years in Girl Scouts: Current Position(s) in Girl Scouts: The candidate is being NOMINATED by: Name: Service Unit: Address: City: Zip: Phone :( ) Email: 1. Is the candidate a registered Girl Scout member now and throughout the time period when the service was given? Yes No 2. How did you become aware of the candidate s accomplishments?

3. Please describe the activity/activities this candidate implemented to support the delivery of the Girl Scout Leadership Experience in one geographic area. 4. In what community/service Unit area was this service delivered? 5. Over what period of time was the service performed? 6. Who was affected? For adults, include how many in what roles. For girls, include how many, what grade level(s), and in which pathway(s). 7. How were they affected? What outcome did the girls /adults experience, or what did they say they remembered/learned about the experience or activity?

8. What position did the candidate hold and how did the candidate s service go above and beyond the expectations for the positions? What were the goals or expectations? Use specific measurable examples to support their nomination. When providing numbers, please give ratios. 9. How did the candidate demonstrate inclusive behavior? Additional remarks:

Letter of Endorsement Letters of Endorsement MUST be completed by individuals other than family members of the candidate OR the person completing this nomination application. NO HAND WRITTEN NOMINATIONS WILL BE ACCEPTED. Name of Nominee: This endorsement submitted by: Name: Address: City: Zip: Email: Phone: ( ) In approximately 200 words or less, state your reasons for endorsing this nomination. Be as specific as possible. Please include the following information: Describe in what capacity you are familiar with the nominee s performance/contributions to Girl Scouting. How long you have known this person? Please provide examples of how their involvement in Girl Scouting has been a role model to others? How has the nominee s performance been outstanding and/or beyond expectations of their position? How the nominee s contributions benefited Girl Scouting, be specific and detailed?

Adult Recognitions Leader of the Year Award Checklist Leader Name: Troop #: Service Unit #: Please have the appropriate Council staff member verify the following information: 1. Troop Leader is a registered adult volunteer. (Council Registrar: ) 2. Troop Leader has held position for a minimum of five continuous years. (Council Registrar: ) 3. Troop has maintained current Troop size for at least two years. (Council Registrar: ) 4. Troop Leadership team has completed all required training. (Membership Development Specialist: ) 5. Troop participates in Council and/or Service Unit events. (Service Unit Manager or Program Leadership Manager: ) 6. Financial report submitted on time. (Membership Development Specialist: ) 7. Additional Service has been performed above Troop Leadership. (Service Unit Manager or Membership Development Specialist: ) 8. Attach a minimum of six letters of endorsement, three of which are from parents of the Troop. Please return this form to me by attach additional pages. If you have any questions, please contact me.. If more space is needed, Nominator: Address: City: Zip: Phone: ( _) Email: