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Adult Recognition - Letter of Endorsement

Award

Letters of endorsement must be received by the Council no later than 5:00PM on December 1st.

Name of Nominee *

Nominated For: *

Endorser’s Information (may not be a family member of nominee)

First Name *

Middle Initial

Last Name *

Address 1 *

Address 2

City *

State *

Postal Code *

Primary Phone XXX-XXX-XXX *

Primary Type *

Home

Cell

Work

Secondary Phone XXX-XXX-XXX

Secondary Type

Home

Cell

Work

E-mail Address: *

Confirm: *

In what capacity are you familiar with the nominee's performance/contributions to Girl Scouting?

*

Please state your reasons for endorsing this nomination. Please provide specific examples of:

How the nominee’s performance has been outstanding (or beyond expectations of the position)
How the nominee’s contributions have benefited Girl Scouting
Any other comments or information that might be helpful

*

0/1000 words

First Name of NOMINATOR *

Last Name of NOMINATOR *

Email address of NOMINATOR: *

Submission

Please know that by completing this online form, you are directly providing and sharing all your data, including personal data with a third party service provider who Girl Scouts of Greater Chicago and Northwest Indiana, Inc. ("GSGCNWI") is working with to process this form. The third party service provider wil share your data with GSGCNWI to use and process in connection with your application. By your acceptance below, you acknowledge and agree to hold GSGCNWI harmless from any claims arising from actions or omissions by the third party provider related in any way to the data provided by you. Further, by your acceptance below, you understand, acknowledge and agree that GSGCNWI may share and use the data provided by you in accordance with GSGCNWI's Privacy Policy.

You understand and agree that you have read the provisions on this page, including the permissions. By signing below, you understand that you are providing a binding electronic signature, that communications regarding your agreement with us will be sent by email to the address you have provided.

Signature of Endorser (Type your name) *

Today's Date (MM/DD/YYYY) * +

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