Service Above Self Award PDF Details

The Service Above Self Award Form is a document that recognizes individuals for their exceptional service to others. This form can be used to nominate someone for an award, or to recommend someone for recognition. The dedicated service of recipients is often in the form of time, effort, and personal sacrifice. Thank you letters may also be included with the nomination. This form is designed to provide concise and specific information about the individual being nominated, as well as their outstanding service. Any individual, group, or organization can submit a nomination. Please complete all sections of this form and return it to your local district office. Your district will review all submissions and choose the recipient(s) at the next level of governance.

You will discover information about the type of form you wish to prepare in the table. It will tell you how much time it takes to finish service above self award, exactly what parts you will have to fill in, and so on.

Form NameService Above Self Award
Form Length2 pages
Fillable fields0
Avg. time to fill out30 sec
Other namesservice above award, service above self award, self nomination for award sample, rotary service award

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Rotary’s highest honor recognizes Rotarians who demonstrate Rotary’s motto, Service Above Self, by volunteering their time and talents to help others. The award is internationally competitive and is granted to no more than 150 Rotarians worldwide, and no more than one from each district, each year.


Only district governors, immediate past district governors, RI directors, and past RI directors may honor exemplary Rotarians by nominating them to be considered for this award. Nominate as many as three people by completing this form for each. Type the information asked for below in the space that is provided. Do not attach any supporting materials or additional sheets. Instead, make the case that your nominee deserves this award in your responses to the long-answer questions.

Submit the nomination to Rotary International World Headquarters no later than the close of business

1 October by emailing it to or mailing it to:

Service Support and Awards (PD210)

Rotary International

One Rotary Center

1560 Sherman Avenue

Evanston, IL 60201-3698 USA

RI will notify the governor of the district of each Rotarian who is nominated, in accordance with RI Board policy.


To deserve consideration for the Service Above Self Award, a Rotarian must have performed continuing humanitarian service in any form. This award is intended to recognize especially those who actively help others through Rotary. It is not awarded solely in recognition of one’s performance in an elected or appointed Rotary assignment, and financial contributions to The Rotary Foundation or specific projects will not be considered.


You may not nominate yourself for this award. You may not nominate your spouse, child, grandchild, the spouse of a child or grandchild, or a parent or grandparent. No Rotarian may receive the award posthumously or more than once. Any active Rotarian in good standing may be nominated, except the following:

District governors, governors-elect, or immediate past district governors

RI presidents, presidents-elect, or past presidents

RI directors, directors-elect, or past directors

Rotary Foundation trustees, incoming trustees, or past trustees


Use a separate form for each nominee.









Last name


First name


Classification or former classification

Rotary club













Member ID

Number of years of Rotary membership


To nominate someone for this award, you must be one of the following. Please indicate your role:

Current district governor  Current RI director 

Immediate past district governor  Past RI director









Last name


First name



Rotary club
















Postal code









Phone number


Member ID






















Service Above Self Award Nomination Form

Page 1


General biography:

Rotary service activities, including Rotary positions held:

Non-Rotary service activities:

Describe how this candidate embodies Service Above Self.

Service Above Self Award Nomination Form

Page 2

How to Edit Service Above Self Award Online for Free

It's very easy to fill in the self award nomination empty blanks. Our PDF tool can make it almost effortless to fill out any specific form. Down the page are the only four steps you need to take:

Step 1: Step one will be to click on the orange "Get Form Now" button.

Step 2: So you should be on the document edit page. You can add, modify, highlight, check, cross, insert or erase areas or words.

For each section, fill out the information required by the application.

self nomination sample letters fields to complete

Include the expected information in the Use a separate form for each, Last name, First name, Classification or former, Rotary club, District, Country, Member ID, Number of years of Rotary, NOMINATOR, To nominate someone for this award, Last name, Address, First name, and Rotary club box.

Filling out self nomination sample letters stage 2

The system will ask for further information to be able to instantly fill out the field General biography, and Rotary service activities.

stage 3 to filling out self nomination sample letters

Spell out the rights and responsibilities of the parties inside the space NonRotary service activities, and Describe how this candidate.

Entering details in self nomination sample letters stage 4

Step 3: The moment you select the Done button, the ready document is easily transferable to each of your devices. Or alternatively, it is possible to send it by means of mail.

Step 4: Make sure you remain away from forthcoming difficulties by creating no less than a pair of copies of your file.

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