SMPF Role Models Nomination Form

The St. Mary Parish Foundation is accepting nominations for the St. Mary Parish Role Models Awards.

Role Models are career professionals who are making significant charitable contributions of their time and resources to support nonprofit organizations, churches, and schools in St. Mary Parish. They will be evaluated by the impact they are making in their community.

You can nominate an individual who lives in St. Mary Parish, only.

Nominations are presented to St. Mary Parish Board of Directors who selects the St. Mary Parish Role Model honorees.

Please know that all nominees are considered and a nomination does not imply, suggest or guarantee that the nominee will be selected.

Also, please be aware that nominees do have the option to decline this recognition.

The deadline to submit a nomination is Thursday, January 30, 2020.
Nominee Information

Fill out the form below before submitting.
Is the nominee aware you are making this nomination?
Nominee Name

First NameLast Name
Nominee's Company or Organization Name
For individual/couple nomination, only
Nominee's Job Title
Nominee's Cell Number

Area CodePhone Number
Nominee's Work Phone Number

Area CodePhone Number
Nominee's E-mail
Nominee's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Fill Out Chart Below

(1) List the nonprofit organizations, churches, schools, individuals or groups to whom the nominee has directed his/her philanthropic (charitable) efforts. (2) Include the approximate number of years the nominee has been associated with each organization listed in column one. (3) Include if the nominee was a Donor, Volunteer Fundraiser, and/or Volunteer with the organization listed in column one.

Rows	Organization, Church, School, Individual or Group Name	Approximate Number of Years of Involvement	Donor	Volunteer Fundraiser	Volunteer
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2
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4
5
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8

Briefly describe the nominee's philanthropy
In 1,000 words or less, explain why your nominee is best qualified to receive the award and how they are impacting nonprofit organizations, churches, schools, and communities.

0/1000
Upload additional information to support this nomination, optional

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Nominator Information
Your Name

First NameLast Name
Your Company or Organization's Name
Your Job Title
Cell Phone Number

Area CodePhone Number
Work Phone Number

Area CodePhone Number
Home Phone Number

Area CodePhone Number
E-mail
Your Primary Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty:

Nominee Information

Fill Out Chart Below

Briefly describe the nominee's philanthropy

Nominator Information