Adult Recognition D.A.I.S.Y. Award Submission

Save & Return Account (recommended)

New Users / Returning Users CLICK HERE to setup or return to your account for this form. Creating an account enables you to return to this form and your submitted results. An account will also enable you to partially complete this form and return later to finish. The account you establish is only for this form. You may use the same user name and password as your MyGS account if desired.

Recognition Award Nomination

The Dynamic And Incredible Staff of the Year Award recognizes the outstanding work of a staff member.

The D.A.I.S.Y. award recognizes the outstanding service that:

Has resulted in the development of partnerships with volunteers and/or community leaders to at least one service unit or program delivery audience toward the achievement of the council’s goals
Will benefit the entire council beyond the staff member’s tenure
Goes far beyond the expectations of the employee’s job description
Supports the achievement of the council’s goals and strategic learning efforts
This award will be presented to only 3 people per year.

Criteria:

The candidate is a registered Girl Scout staff member.
The candidate has provided outstanding service to at least one geographic area or program delivery audience in a way that advances the council’s goals.
The candidate must have a minimum of three (3) years in the staff position.
The candidate’s service goes far beyond the expectations for the position.
Two individuals or groups who are familiar with the candidate’s service must submit letters of endorsement, one letter must be from a volunteer, or a group of volunteers and one must be from a staff member.
This award will be presented to only 3 people per year.
Reviewed first by the Human Resources department to insure the candidate is in good standing with the Council, and then sent on to the awards screening task group for review of the additional criteria
Receives final approval from the Board of Directors

APPLICATION DEADLINE DATE:

All nominations must be submitted by 5:00 p.m. December 1st.

Nominee Information

Please note that fields marked * are required. All other fields are optional.

First Name *

Middle Initial

Last Name *

Address 1 *

City *

State *

Postal Code *

Primary Phone
Format: 000-000-0000 *

Primary Type *

Home

Cell

Work

Secondary Phone
Format: 000-000-0000

Secondary Type

Home

Cell

Work

E-mail Address: *

Confirm E-mail Address: *

Nominee's adult years and positions

Please enter nominee's adult years in Girl Scouting, if known.
(for information only; not used as a criterion for recognition)

Please list nominee's current position(s) and years held (if known). Please include voluteer and/or staff positions.
Format: Troop Leader 2012 to Present

+-

Please list nominee's previous position(s) and years held (if known). Please include voluteer and/or staff positions.
Format: Troop Leader 2012-2014

+-

Did this nominee receive any of these awards? *

Year award was received? *

Volunteer of Excellence

Year award was received? *

Appreciation

Year award was received? *

Honor

Year award was received? *

Thanks Badge

Year award was received? *

Thanks Badge II

Please list other award(s) received and year awarded (if known)
Format: DAISY 2012

+-

Nominee's Qualities and Impact

Girl Scout Leadership Experience Volunteer Qualities *

	Area of concern	May be in place, but not evident	Occasionally evident	Excellence in this area is evident	Does Not Apply
Girl Focus (fun, interactive, respectful, provides girl led experiences)	Area of concern	May be in place, but not evident	Occasionally evident	Excellence in this area is evident	Does Not Apply
Adaptability (flexible, modifies own behavior, capable of understanding, has a sense of humor)	Area of concern	May be in place, but not evident	Occasionally evident	Excellence in this area is evident	Does Not Apply
Good Oral Communication (clear, concise, accurate, listens, clarifies, and facilitates)	Area of concern	May be in place, but not evident	Occasionally evident	Excellence in this area is evident	Does Not Apply
Fosters Diversity (values, nurtures, understands, and embraces diversity/differences)	Area of concern	May be in place, but not evident	Occasionally evident	Excellence in this area is evident	Does Not Apply
Personal Integrity (dependable, credible, honest, responsible for own actions)	Area of concern	May be in place, but not evident	Occasionally evident	Excellence in this area is evident	Does Not Apply

The nominee has had impact in the following functional areas:

(Please select as many as apply)

*

Please describe how the nominee provided service beyond the expectations of the position and has supported GSGCNWI's mission-delivery goals in the areas indicated above:
Remember: Those who review the nominations may not know the nominee and/or the great accomplishments (s)he has given to Girl Scouts. This is your opportunity to let everyone know! *

0/1000 words

Nominator's Information

First Name *

Middle Initial

Last Name *

Position of individual submitting nomination: *

Address 1 *

City *

State *

Zip Code *

Primary Phone
Format: 000-000-0000 *

Primary Type *

Home

Work

Cell

Secondary Phone
Format: 000-000-0000

Secondary Type

Home

Work

Cell

Letters of Endorsement

Please list names, positions and contact information for individuals submitting letters of endorsement. Letters of endorsement may not be written by family members. Endorsements may be written by non-Girl Scout adults familiar with the nominee's work. For example, a school principal, a teacher, a clergy member, an adult from a collaborating organization, etc.

If an endorser DOES NOT have access to submit on-line, you may upload a legible letter of endorsement.

Person 1:

First Name

Middle Initial

Last Name

Position

Primary Phone
Format: 000-000-0000

Primary Type

Home

Work

Cell

Secondary Phone
Format: 000-000-0000

Secondary Type

Home

Work

Cell

E-mail Address:

Confirm E-mail Address:

Upload legible letter of endorsement:

Person 2:

First Name

Middle Initial

Last Name

Position

Primary Phone
Format: 000-000-0000

Primary Type

Home

Work

Cell

Secondary Phone
Format: 000-000-0000

Secondary Type

Home

Work

Cell

E-mail Address:

Confirm E-mail Address:

Upload legible letter of endorsement:

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 Nominator (Type your name) *

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

Enter the word in the image *
captcha

Membership Registration	Community cultivation	Volunteer Relations and Support
Program	Leadership and Governance	Fund Development
Council Office support and service	Product Sales	Recruitment
Training/Adult Learning

No	Unknown	Volunteer of Excellence
Appreciation	Honor	Thanks Badge
Thanks Badge II