Nominee Application

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$Text Box: UPLIFT "2010" COMMUNITY UNSUNG LEADERSHIP AWARDS NOMINATION FORMAT GUIDELINES All letters of nomination must follow the format listed below. Please review Uplift "2010" Community Unsung Leadership Awards Guidelines before preparing your nomination. Complete one letter of nomination for each nominee/team. Provide as much detail and anecdotal information as possible on your candidate(s). Self-nominations are accepted. All nominees will be notified that they are under consideration. Email your nominations to info@upliftfoundation.org. If you have any questions, contact Solomon Miles at (202) 291-4688, Ext. 4 or info@upliftfounation.org Nominations must be received by October 04, 2010 Nominee Information: Full Name: Title/Organization: Mailing Address: City: State: Zip Code: Daytime Telephone Number: Evening/Cell Phone: Email Address: Age: Gender: Race/Ethnicity of Nominee: Check all that apply ___African-American or Black ___ American Indian or Alaskan native ___ Asian or Pacific Islander ___ Caucasian ___ Hispanic/Latino ___ Other: Please explain: In what part of the Washington, DC metropolitan area does the nominee live/work/volunteer? Check all that apply: ___ Washington, DC ___ Montgomery County, MD ___ Prince George's County, MD ___ Arlington County, VA ___ Fairfax County, VA ___ City of Alexandria, VA ___ City of Falls Church, VA ___ Loudoun County, VA ____ Others II. Your Information. Full Name: Title/Organization: Mailing Address: City: State: Zip Code: Daytime Telephone number: Email Address: Relationship to Nominee: III. References: Please list the names, phone numbers and email addresses of two (2) other people who could talk about this nominee (s)' accomplishments. These individuals may be contacted during the selection process for more information. References may Include a colleague from within the organization: an acknowledged community leader; or community member. Reference1: Reference 2: On each reference, Please include: Full Name: Title/Organization: Mailing Address: (Street Address) City: State: Zip Code: Daytime Telephone Number: Email address: Relationship to Nominee: IV. Letter of Nomination: 1. Describe how this nominee is making a difference in the community? What is unusual or creative about the contribution? Please give one or two examples: (2,500 characters with space (approximately 400 words) 2. How does the nominee show initiative? is the nominee's contribution " above and beyond "their paid work or the usual volunteer commitment. Please give one or two examples. (2,500 characters with space (approximately 400 words) 3. Does the nominee attract and inspire others to community work or leadership? Please describe and give specific examples. (2,500 characters with space (approximately 400 words) 4. Is the nominee a visionary- "A shaper of what could and might be"? How does he/she communicate or demonstrate this vision. Please be specific in your description. (2,500 characters (approximately 400 words) 5. Would you like to share any other stories or events that would sum up the nominees work and illustrate why he/she should receive the Uplift "2010 Community Unsung Leadership Awards. (2,500 characters with space (approximately 400 words)} 6. Has the nominee received any awards of other recognition for his/her community service and leadership. If so, how? {600 characters with spaces (approximately 100 words}$

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