2019 Volunteer Recognition Program Nomination Form

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Please note that all nomination forms must be received by Friday, March 15th, 2019 at 5:00 p.m. in order to be considered for public recognition at the meeting of the Merced County Board of Supervisors. Should you have any questions regarding the nomination process, contact Mike North at (209) 726-2744.

Note: Complete only one of the sections below. Complete either "Individual Nominee/Volunteer Information" or "Organization Nominee Information", but not both.

Individual Nominee/Volunteer Information

(Or) Organization Nominee Information

Please Complete all sections below


Verification

In order to qualify for consideration, a nominee must have one referee that may be contacted to verify the scope/extent of the nominee’s volunteer activities. The Referee should be familiar with the accomplishment(s) for which the volunteer or organization is being nominated. The Referee may not include the nominator, the nominee or any person related to the nominee.


Nominator (name of person nominating individual or group for recognition)

Attachment


DEADLINE TO RECEIVE NOMINATIONS IS 5:00 P.M. Friday, March 15th, 2019.
 
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