PHILADELPHIA EAGLES COMMUNITY QUARTERBACK AWARD
2011-12 Nomination Form
Nomination forms must be completed with all required information and returned to Community Quarterback Award at Philadelphia Eagles, NovaCare Complex, One NovaCare Way, Philadelphia, PA 19145-5996.
All completed applications must be postmarked no later than April 2nd, 2012 to be eligible for consideration for the 2012 Community Quarterback Award presented by Teva Pharmaceuticals. Individuals can nominate themselves or others for the award.
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Nominee Information
Please provide in this section some basic information regarding the person you are nominating for the Community Quarterback Award.
First and Last Name ______
Email address ______
Mailing address ______
Telephone # ______
Age as of 4/2/2011 ______
Name of nonprofit (501c3 or 509) organization served by nominee and tax ID #
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Mailing address of nonprofit organization ______
Telephone # of nonprofit organization ______
Description of non-profit organization ______
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Nominator Information
Please leave this section blank if you are nominating yourself. Those nominating others must complete all fields below.
First and Last Name ______
Email address ______
Mailing address ______
Telephone # ______
How long have you known the nominee? ______
In what capacity do you know the nominee? ______
Description of Nominee’s Volunteer Work
This section must be completed in full. If you are nominating yourself, please describe your experiences as a volunteer and your qualifications for the Community Quarterback Award. If you are nominating another person, please describe what makes that volunteer deserving of recognition.
Please describe the nominee’s work as a volunteer. Discuss the capacity in which the nominee has served and the length/duration of service.
How has the nominee improved the lives of others in the community through his/her volunteer work? Please describe why the service(s) provided has been needed and what impact it has had.
In what ways has the nominee demonstrated a strong commitment to community service? Please provide specific examples of ways in which the nominee has shown extraordinary dedication to improving the community in which he/she lives through volunteerism.
What sets the nominee apart and makes him/her deserving of recognition? What challenges has the nominee faced in his/her volunteer work?
*Please feel free to attach one additional page if there is anything else that you would like to tell us about your nominee.
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