The winner will be recognized in the Spring at a formal banquet with the Governor.
Do you know someone who is an amazing volunteer and asset to our community then you should nominate them for the Governor’s Volunteer Star Award!
An Award Will Be Given To One Adult & One Youth
The winner will be recognized at the the December County Commission meeting and again in the Spring at a formal banquet with the Governor.
There are several places you may pick up an application: The Center in Springfield, The Senior Center, The Courthouse, UT Extension and County Office Building.
County Award Recipient Form – Adult
Adult Honoree
Please provide a brief biography of your county’s adult award recipient answering the following questions in 500 words or less:
1. What make the honoree an outstanding volunteer?
2. What agency(s) do they serve with? How long have they served with this agency?
3. What type of service do they perform?
4. How does their service impact their community?
5. What makes the honoree unique?
Adult Award Recipient Information
Name:
Address
City ZIP___________________________________
Home Phone __________________________ Work Phone ___________________________
Volunteer Service Performed:
Does the service performed address low-income issues? (Check one) Yes ____ No ____
County Information
County Name: Robertson County
County Mayor: Howard Bradley
County Coordinator: Jodi Ballard
County Coordinator Contact Information:
108 Courthouse Square
Springfield ZIP: 37172
Work Phone: 382.2244
Email: [email protected]
Recipient Form – Adult Page 1 of 2
Nominator Information
Nominator Contact Information:
Name Phone_____________
Address
City ZIP___________________________________
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