Girl Scout Council of the Mid-South

Outstanding Volunteer Nomination Form

Fields marked with an asterisk * are required.
Nominee's First Name:*
Nominee's Last Name:*
Address:*
City:*
State:*
Zip:*
Day Phone:*
Evening Phone: 
E-mail Address: 
Volunteer Position: 
Name and date of training(s) completed that is required for position: 
The information contained in the nomination should be objective and result-oriented, giving pertinent facts, dates, positions held, etc. State clearly and concisely the candidate's outstanding leadership skills, communication Skills (at council, service unit, troop levels), and membership skills.
1. Describe service: 
2. Provide information about the audience benefiting from the service and the impact the service has had on the geographic/service unit beyond the expectations of the position held: 
Person completing form
First Name:*
Last Name:*
Address:*
City:*
State:*
Zip:*
Home Phone:*
Work Phone: 
E-mail Address: 

                             
You may submit form electronically by clicking submit or print and deliver to the
Girl Scout Council of the Mid-South
Mail: PO Box 240246, Memphis, TN 38124-0246
Deliver: 2715 Kirby Parkway, Suite 1
Fax: (901) 797-2183