Citizenship & Service Award
2017Nomination Form
Please complete the following information in addition to providing a narrative summary about the nominee’s service activities as it pertains to the selection criteria listed below.
Nominee’s Information
Nominee’s Name: ______
Title / Company (if employed): ______
Address: ______
City: ______State: ______Zip: ______
Telephone: ______E-Mail Address: ______
Nominator’s Information
Nominator’s Name: ______
Title / Company (if employed): ______
Address: ______
City: ______State: ______Zip: ______
Telephone: ______E-Mail Address: ______
The Selection Criteria shall include:
1.The award recipient shall demonstrate a commitment to service and /or civic participation over a sustained period of time.
2.The award recipient participates in activities that set a standard and foster a culture for citizenship, service and community responsibility.
3.The award recipient shall demonstrate one or more of the following business values:
IntegrityStewardship
InclusionInitiative
TeamworkAccountability
Narrative Summary
On a separate sheet of paper, please address the following items. Please limit your responses to no more than two, typed pages. Responses should be typed or printed clearly in ink.
1.Share examples of the nominee’s commitment to service and/or civic participation over a sustained period of time.
2.Describe how the nominee’s activities have set a standard and fostered a culture for
citizenship, service and community responsibility.
3.Share several examples of how the nominee has demonstrated one or more of the following
business values:
•Integrity…Behave ethically
•Stewardship…Care about people and the world in which we live
•Operate safely, be environmentally responsible, strengthen our communities
•Inclusion…Value diversity and respect the dignity of each person
•Value differences in people & perspectives, build relationships based on mutual trust, recognize the contributions of every individual
•Initiative…Lead the way
•Demonstrate the courage and creativity to shape the future
•Teamwork…Work together to achieve superior results
•Share ideas and talents to achieve superior results, support and rely on each other, demonstrate clear and open communications
•Accountability…Take responsibility for actions
•Live our values, set clear goals, measure results, and seek to improve, build and protect
reputation
Questions?
Please contact Angelle LaBorde, (864) 889-9312
Deadline & Submission:
Return your nomination to the Greenwood Chamber by Wednesday, June 7, 2017 by 5:00 p.m.
Fax: (864) 229-9785
E-Mail:
Deliver to: Angelle LaBorde, c/o Duke Energy’s Citizenship & Service Award
Greenwood Chamber, 110 Phoenix St., Greenwood, SC 29646
Mail to:Greenwood Chamber, P.O. Box 980, Greenwood, SC 29648-0980