Adult Recognition Nomination

Adult Recognition Nomination
The adult recognition program at GSSJC offers National and Council award pins, plaques and certificates for outstanding service and accomplishments that go above and beyond the expectations for that role. Submit complete nominations using the online submission form to the Council Adult Recognition Committee by March 1. Recognition nominations which are incomplete will not be considered. Late nominations will be returned to first signer to nominate the following year.
Nominee Information
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Home Phone*
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Current Position in Girl Scouting
Region
Choose Nominee Region, or unknown
Community
Choose Nominee Community, or unknown
Is the nominee a current Girl Scout member in good standing?(Member, CBC on file, not on the debt list)*

YesNo
Adult Years of Service in GSSJC*
Adult Years of Service in Other Councils
If applicable
Girl Years
If applicable
Previous national or council awards received and year, if known
Last Years of Service pin received and the year received (adult volunteer years)
Last Years of Membership Pin received and the year received (adult plus girl membership years)
How has the nominee delivered service beyond expectation of the position held?
Cut and paste text into boxes for best results.
List the impact and results of this nominee's actions:
Cut and paste text into boxes for best results.
Specific audience benefiting from service
Nominator Information

The “first signer” on the nomination will be the primary contact for this nomination and will be notified of the nomination status.

Download F-54A Letter of Endorsement
Nominator's Full Name*

First NameLast Name
Nominator's Phone*
Please enter a valid phone number.
Nominator's Email Address*
example@example.com
Upload Nominator's Letter of Endorsement*

Cancelof
Registered Nominator #2*

First NameLast Name
Registered Nominator #2's Phone*
Please enter a valid phone number.
Upload Nominator #2's Letter of Endorsement*

Cancelof
Registered Nominator #3*

First NameLast Name
Registered Nominator #3's Phone*
Please enter a valid phone number.
Upload Nominator #3's Letter of Endorsement*

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Volunteer Record

Volunteer record is required to submit a nomination. Please complete the form and upload.

Download F-122 Adult Volunteer Record
Upload Volunteer Record *

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Award Presentation
All nominations must be submitted no later than March 1, 2025. Please select the method of presentation if an award is granted.*

Adult Recognition Event, April 12,2025Council Meeting (Fall)Community Event (Spring/Summer)Community Event (Fall)
Name and Date of Other Function:
Remember that you can create your own local, customized award to meet your Community needs!
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Adult Recognition Nomination

Nominee Information

Award Presentation