Regional Award of Merit Nomination Form

*NEW* NIRSA SERVICES CORPORATION

The Sarah Fain Distinguished Service Award
Highlighted sections are required fields.

Nominee Name / Phone
Institution / Alt Phone
Address / Email 1
City / State/Province / Zipcode / Email 2
NIRSA Region (select one): Choose an item.
Membership status (select one):ProfessionalLifeAmeritus
Nominees for the award are required to meet all of the following eligibility requirements and have demonstratedexceptional cumulative efforts made through years of dedication to the NIRSA Championship Series.(If this nomination is for one-time service to the Region or NIRSA in the past year, it is recommended this person be nominated for a NIRSA Annual Service Award):
  • Hold current professional membership in NIRSA
  • Have held continuous membership in NIRSA for three years preceding the award nomination Has never received the Sarah Fain Distinguished Service Award
  • Have volunteered at multiple NIRSA Championship Series Events at the Regional or National level
  • Receive a nomination from a current member who has volunteered with the NIRSA Championship Series
  • It is recommended that the current NIRSA Championship Series committee members not be nominated
Selection Criteria
To illustrate how your nominee exemplifies outstanding service to the NIRSA Championship Series, please describe how your nominee contributed to one or more of the following areas:
  • Leadership of a pioneering nature in the formulation or development of Championship Series activities
  • Sustained, excellent performance as a volunteer over 3 or more years
  • Significant contributions that had a direct impact on NIRSA Championship Series Events
  • Extraordinary dedication or creativity exhibited as a member of a NIRSA Championship Series Event
  • Significant contributions to NIRSA Championship Series guidelines, policies, special projects, publications, or event management
  • Tireless dedication to getting the details correct, being a team player, improving the participant experience, and doing whatever it takes to get the job done

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Regional Award of Merit Nomination Form

Nominator information

Highlighted sections are required fields.

Name / Phone
Institution / Alt Phone
Address / Email 1
City / State/Province / Zip code / Email 2
*Please list at least 1 Series event you were involved with *
Position: Click or tap here to enter text.
Date: Click or tap here to enter text. Location: Click or tap here to enter text.

Submitting this form

Once you have completed this form in full, please attach to an email and send it, along with the nomination letter and any additional materials supporting your nomination, tothe Director of National Sport Programs, Valerie McCutchan. To facilitate more efficient processing of your nomination materials, please use a subject line like“Sarah Fain Award nomination for JaneDoe”. If you have any difficulties completing this form, please contact Leadership Programs Coordinator, Lani Beavers.

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