Jeff Garrett Community Service Award Nomination Form
This is your opportunity to acknowledge outstanding professionals and community leaders within your organization or whom with you conduct business. The Jeff Garrett Community Service Award is designed to recognize an individual who exemplifies outstanding service to Jefferson County by their actions and contributions to the community outside the workplace.

Judging Criteria: A panel of judges will independently score each of the nominations based on their written application.

Qualifications:

  1. Individual has made major contributions to the quality of life in Jefferson County. 
  2. Individual is a resident of Jefferson County in good standing.
  3. Individual has distinguished himself/herself through outstanding service to Jefferson County in one or more of the following areas: community service projects, youth work, civic club service, church activities, civic improvement projects, philanthropy, or economic development.
  4. Individual has a positive public image and strives toward professional accomplishment. 
  5. Individual has served the community outside the workplace.
  6. Individual is not a previous Jeff Garrett Community Service Award Recipient.
  7. Individual is not a current elected political official. 
  8. Individual has exemplary public image favorable to Chamber goals.
  9. Individual has given extra effort to business issues.

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Please provide the following information:

Name of Nominee:

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Home Address of Nominee:

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Work Address of Nominee:

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Email Address of Nominee:

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Phone number of Nominee:

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Name of Sponsor:

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Sponsor home address:

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Sponsor Email:

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Sponsor Phone Number

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Relationship to Nominee

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Please list and describe the significant contributions that the nominee has made to their organization(s) including involvement, offices held, and period of time in each.

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Please list examples of the nominee's professions contributions.

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Please list specific examples where the nominee has demonstrated leadership roles in community service and how his/her contributions have benefited the community.

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Please provide a brief background of nominee's work experience in Jefferson County.

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Please provide a brief background of their family history (optional).

Please list any additional information you would like the selection committee to consider.

Type your name below if the information you have provided on this form is accurate and true to the best of your knowledge. 

Do not submit if the information you provided is inaccurate or false. 

Thank you for your participation in the Chamber Awards nominations! 

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