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.
| Question | Answer |
|---|---|
| Form Name | Service Above Self Award |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | nomination for quality award example, self nomination for award sample, rotary service above self award, self award nomination sample |
SERVICE ABOVE SELF AWARD NOMINATION FORM
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.
HOW TO NOMINATE A CANDIDATE
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
Submit the nomination to Rotary International World Headquarters no later than the close of business
1 OCTOBER by emailing it to riawards@rotary.org or mailing it to:
Service Support and Awards (PD210)
Rotary International
One Rotary Center
1560 Sherman Avenue
Evanston, IL
RI will notify the governor of the district of each Rotarian who is nominated, in accordance with RI Board policy.
CRITERIA
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 inancial contributions to The Rotary Foundation or speciic projects will not be considered.
ELIGIBILITY
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,
•RI presidents,
•RI directors,
•Rotary Foundation trustees, incoming trustees, or past trustees
NOMINEE
Use a separate form for each nominee.
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NOMINATOR
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 |
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Service Above Self Award Nomination Form |
Page 1 |
QUALIFICATIONS
General biography:
Rotary service activities, including Rotary positions held:
Describe how this candidate embodies Service Above Self.
Service Above Self Award Nomination Form |
Page 2 |