Fernando award nomination form

2018 FERNANDO AWARD

NOMINATION FORM

Who should be nominated? A nominee for the Fernando Award must be making a difference! They should reside or work in the San Fernando Valley and have exhibited impressive leadership and exceptional effort in support of a variety of valley-wide civic and community programs and causes. All residents and community organizations of the San Fernando Valley are encouraged to participate in the nomination process.
A nominee can be nominated by an individual or organization and can be nominated by a maximum of two persons or organizations.
Current or former public officials, candidates for political office, members of the Board of Directors, employees of Fernando Award Foundation and past recipients are ineligible for nomination.
Before you nominate. To assist you with the nomination process, you can contact Gary M. Thomas, Past Recipient, at [phone] or email [e-mail] prior to filling out the nomination package. He is available to answer any questions you may have and will help make the nomination process as simple as possible.
The nomination package. Complete the information in the Nomination Package. Your completed package should include:

1) Complete and sign the Nominator/Nominee Acknowledgement page. This should be completed and signed by the one or two nominators and the nominee.

2) Complete the Nominee/Nominator Contact page.

3) Provide a Biographical Resume of the nominee’s volunteer and achievement history. A sample of information that can be included is listed in this package. This should be provided single sided from one to a MAXIMUM of four pages as should be as complete as possible in summarizing the nominee’s service and impact as a volunteer to the San Fernando Valley.

4) Supply a color photograph of the nominee. This will be supplied to the media along with nominee biographical information. The photo should be at least 4” x 6” at 300dpi and should be emailed to [e-mail].
Deadline for submission. The Nomination Packet and required material described above must be received by Fernando Award Foundation, Inc. at the address below or via email no later than Tuesday, July 31, 2018.
NOMINATOR/NOMINEE ACKNOWLEDGEMENT
IMPORTANT NOTICE: Any political or other types of campaigning, advertising, solicitation or promotions by any person or group on behalf of a person being proposed as a nominee, or a person who has been nominated for the Fernando Award, shall be grounds for disqualification of said person. Disqualification shall be solely the prerogative of the Board of Directors.
NOMINATOR’S ACKNOWLEDGEMENT:
An individual can be nominated by an individual or organization and can be nominated by a maximum of two persons or organizations.
I, as the authorized nominator of (nominee name) ,

do acknowledge that I have reviewed the Nominee’s responsibilities with the Nominee and have secured his/her commitment of compliance to all of the conditions of the nomination. If nominating on behalf of an organization, I do hereby assure the Fernando Award Foundation, Inc., that I have been authorized to make this nomination by the governing body of such organization.

It is understood that the decision of the Selection Committee in choosing the Finalists is final, and I agree that Fernando Award Foundation, Inc., has the sole authority in all matters related to the Award, the Award Dinner and the Annual Meeting.
______________________________________ ______________________________________

Name of Nominator/Organization Name of Second Nominator/Org. (if applicable)

______________________________________ ______________________________________

Signature of Nominator/Organization Rep. Signature of Second Nominator (if applicable)

NOMINEE’S ACKNOWLEDGEMENT:
NOMINEE’S RESPONSIBILITIES:

I, ____________________________________________, am pleased to accept the honor of being considered as a Nominee for the Fernando Award. I hereby authorize my name to be placed into nomination for the Fernando Award and agree to fulfill the following responsibilities:

1. Attend the Fernando Award Dinner on Saturday, October 6, 2018. If selected as the 2018 recipient, attend the Fernando Annual Meeting in January 2019 and other possible events during such reasonable hours as may be requested by Fernando Award Foundation, Inc.

2. Provide a personal biographical sketch by Tuesday, July 31, 2018, in the format requested by Fernando Award Foundation, Inc.

3. Assist The Fernando Award Foundation, Inc., when possible, in the furtherance of promoting the mission of volunteerism.

4. Be present for reasonable photo sessions, interviews, press conference and promotional activities.

AGREED: _______________________________________________________________________

Signature of Nominee

NOMINEE/NOMINATOR CONTACT INFORMATION
NAME OF NOMINEE
__________________________________________________________________________________

Name of Nominee

__________________________________________________________________________________

Business Affiliation

__________________________________________________________________________________

Business Address

__________________________________________________________________________________

Business Phone Fax

__________________________________________________________________________________

E-mail

__________________________________________________________________________________

Home Address

__________________________________________________________________________________

Home Phone

NOMINATED BY:

__________________________________________________________________________________

Name of Organization or Individual (As you want it listed in the ballots and program)

__________________________________________________________________________________

Address

__________________________________________________________________________________

Name of Contact (if organization)

__________________________________________________________________________________

Phone Fax

__________________________________________________________________________________

E-mail

Complete the following if nominated by a second organization or individual (optional)
__________________________________________________________________________________

Name of Organization or Individual (As you want it listed in the ballots and program)

__________________________________________________________________________________

Address

__________________________________________________________________________________

Name of Contact (if organization)

__________________________________________________________________________________

Phone Fax

__________________________________________________________________________________

E-mail
NOMINEE’S RECORD OF ACHIEVEMENT

Provide a Biographical Resume of the nominee’s volunteer and achievement history. This should be provided single sided from one to a MAXIMUM of four pages as should be as complete as possible in summarizing the nominee’s service and impact as a volunteer to the San Fernando Valley.
Tell the nominee’s personal story however you wish. Supplied information could include:
• Description and dates of volunteer activity including organizational involvement and leadership positions held. Please be specific about the nominee’s personal involvement and who benefited from their participation and in what way.
• Organization memberships or record of any awards received.
• Any additional information that might be helpful in the evaluation of the nominee’s background of volunteerism.

Supply a color photograph of the nominee. This will be supplied to the media along with nominee biographical information. The photo should be at least 4” x 6” at 300dpi and should be emailed to [e-mail].

Deadline for submission

The Nomination Packet and required material described herein must be received by Fernando Award Foundation, Inc. at the address below or via email no later than Tuesday, July 31, 2018.

Version 06/12/18

Submit packet to: Fernando Award Foundation, Inc.

17412 Ventura Blvd., #263, Encino, CA 91316 or via email to [e-mail]

www.FernandoAwards.org