The State, University & UW Health Employees Combined Campaign of Dane County

Award Nomination Form

Partners in Giving Award Nomination Form

Award criteria :

Doug Palm Community Service Award

Volunteer demonstrating creativity, resourcefulness, enthusiasm, integrity and outstanding achievement.

Partners in Giving Excellence Award

A dedicated reliable, grassroots involved person who did an outstanding job in making the campaign a success.

Robert A. Alesch Award

Volunteer who has served in multiple Partners in Giving leadership roles over an extended period.

Partners in Giving Innovation Events Award

Individual or individuals within an agency, school or unit who initiated or conducted a special event or events which measurably improved the agency’s, school’s or unit’s campaign over prior years. Volunteers may be nominated for one award only.

Please send submit nomination forms by January 20, 2017

Your Name (required)

Your Email (required)

Nominee(s) (required)

Please indicate the nominee(s) preferred names to indicate on the award (e.g. Thomas or Tom)

Nominee(s) Dept./Agency/School (required)

Please describe in detail the reasons for nominating this individual.(e.g. If the individual created and planned a special event, please provide the event name and detailed description). You may include the description below or attach your document to this form. Thank you for making this nomination. (required)