Utah Philanthropy Day - Lt. Governor’s Public Service Award

English

Public Service is defined as promoting the quality of life in a community, through both political and non-political processes. The Lieutenant Governor’s Public Service Award honors an individual who has improved their community through public service. Minimum qualifications are 5 years of continuous or near continuous service. This can include serving in a public service role (professional or volunteer capacity) as well as advocacy efforts, awareness campaigns, and community organizing and activism.

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Nominee's Information

Nominee's Full Name *

Nominee's Current Organization *

Nominee's Email *

Nominee's Phone *

Mailing Address *

City *

State *

Zip Code *

Nominator Information

Nominator's Full Name *

Nominator's Current Organization *

Nominator's Email *

Nominator's Phone *

Mailing Address *

City *

State *

Zip Code *

Questions

English

Please respond to the following questions in the space provided. Please limit responses to 500 words.

Submissions will not be evaluated based on grammar or spelling.

Utah Philanthropy Day recognizes that Utah’s diverse and multicultural communities are a vital part of the philanthropic community. As such, translation services will be available as needed. We are committed to hosting an inclusive event, and encourage organizations to nominate individuals of all language abilities.

If you need this nomination form translated into a language other than English or Spanish, please contact event@utahphilanthropyday.org.

Español

1. Tell us about the many ways that this nominee has been involved within your community. Please be sure to include years of service and the various capacities in which they promote the quality of life. *

Cuéntenos de qué maneras el nominado se ha involucrado con la comunidad. Asegúrese de incluir los años de servicio y las diversas capacidades con las que promueven la calidad de vida.

2. Briefly explain the quantifiable impact this nominee has had within the community. *

Explique en pocas palabras el impacto cuantificable que este nominado ha tenido dentro de la comunidad.

3. Describe this nominee's involvement with public service. *

Describa la participación del nominado en el servicio público.

4. Describe how this nominee has demonstrated their commitment to and advancement of diversity, equity, and inclusion. *

Describa cómo este nominado ha demostrado su compromiso con y el avance de la diversidad, la equidad y la inclusión.

5. Describe how this nominee exemplifies humanitarian leadership in the community. Please use this space to mention any qualities, contributions, or impacts that may not have been highlighted in answers to previous questions. *

Describa cómo este nominado ha sido ejemplo de liderazgo humanitario en la comunidad. Use este espacio para mencionar cualidades, contribuciones o impactos que no se hayan destacado en sus respuestas a las preguntas previas.

Terms of Nomination *

Should the nominee be selected, I, as the nominator for this award agree to serve as liaison with the award recipient in the acceptance of the award, and coordination of the media and/or video production.

Signature *

Message

Lt. Governor’s Public Service Award

English

Español

Nominee's Information

Nominator Information

Questions

English

Español

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