List the results of the nominee’s actions and the impact on their girls on the service unit level:
How is this nominee a “sister” to every Girl Scout?:
Please list the individuals who are submitting letters of endorsement:
(Please note: The individual submitting the award nomination cannot write a letter of endorsement for that
nomination.)
1. Name:
Address:
Position
Street
City
Phone-Day:
State
Zip
State
Zip
Email:
2. Name:
Address:
Position
Street
City
Phone-Day:
Email:
Name of person submitting nomination form:
Signature:
Date:
Position:
Address:
Phone:
Email:
Recognition Review Committee:
Approved Yes No
Review Committee Signature
Comments
Date
Board of Directors Review:
Approved Yes No
Board Signature
Comments
Date
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