Judy Murphy Award Application
CANDIDATES FOR THE
JUDY MURPHY “CELEBRATING WOMEN’S LIVES” AWARD SHOULD MEET AT LEAST ONE OF THE FOLLOWING STANDARDS:
- Has a passion for helping others
- Is compassionately concerned for other people
- Has a servant’s heart
- Has vision for greater good in face of adversity
- Is a problem solver
(Nominees must reside in Florida. For additional comments, attach sheets if necessary.)
Name___________________________________________________________
Address______________________________City____________Zip__________
Phone_____________________E-Mail_________________________________
Background_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Organization(s) Volunteered For In The Past 12 Months____________________
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Volunteer Activities And Achievements: (Describe the volunteer activities the individual has been involved with, and the achievements and accomplishments the individual has accomplished in these endeavors.) ______
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Impact On Organization: (Describe the impact the individual’s efforts have had on the organization they volunteer for, or the community at large. Include information regarding number of people served, organizations benefited, funds raised, or other relevant information as appropriate.) ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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TO BE COMPLETED BY THE NOMINATOR
Nominator’s Name_________________________________________________
Address__________________________City____________State____Zip______
Phone____________________E-Mail__________________________________
Nominator’sComments______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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Signature
Nominee will receive written notification of nomination and nominator.
Deadline for entries: Friday, March 25, 2011
Mail this completed form to:
Tom Murphy
2626 Bent Hickory Circle
Longwood, FL 327
