26th Annual

City Council Awards

For Outstanding Volunteers

NOMINATION FORM

Nominations Due: Wednesday, January 18 2017

Awards Ceremony: Wednesday, February 22, 2017

Criteria:

The criteria against which applications will be judged are:

·  The benefit to the community

·  The number of people affected positively by the nominee

·  The length of service

Specifications:

·  An official entry form with supporting narrative must be submitted for consideration by the judges. Your description of the nominee's accomplishments will be crucial to the selection process

·  All nominees must reside within the Escondido General Plan area

·  Individuals may nominate themselves or others

The nomination form is on the reverse side of this paper. Please complete

and return the form (along with supporting narrative) by 5:00 p.m. Wednesday, January 18, 2017 to:

City of Escondido

City Manager’s Office

201 N. Broadway

Escondido, CA 92025-2798

Fax: (760) 839-4578

Information: Michelle Geller

Phone: (760) 839-4587

Email:

Award winners are selected by a Sub-Committee of the City Council, and will be notified in February 2017 of their selection.

Awards will be presented at the State of the City Address and City Council Awards presentation on Wednesday, February 22, 2017.

- Escondido City Council Awards Nomination Form -

Due by 5:00 p.m., Wednesday, January 18, 2017

Nominee's Name: Daytime Phone:

Address: City: State: Zip:

Categories: (Check one)

Arts – Contributions to the fine arts / Historic Preservation – Contributions to historic
Preservation
Business - Contributions to economic development
and business / Public Safety – Contributions to public safety
Community – Contributions to neighborhoods / Youth – Contributions of youth to our community
Education - Contributions to education

Accomplishments:

Please describe the nominee's accomplishments by addressing each of the following points, using no more than three, 8 1/2" x 11" pages. Please type or print your answers.

1. Briefly describe the nominee's activity (indicate what the person or group has done, how it was accomplished, and when the contribution was made).

2. Describe how long the nominee has been involved with this activity.

3. Describe how the community has benefited from this activity.

References: (Names, addresses, and phone numbers of two individuals familiar with your nominee's accomplishments)

Name Name

Address Address

City State Zip City State Zip

() ()

Daytime Phone Number Daytime Phone Number

Name: Daytime Phone:

Address: City: State: Zip:

Email:

Date: Signature of Person Making the Nomination: