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Allen County American Cancer Society
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Allen County American Cancer Society
2008 American
Cancer Society Allen County Appreciation Dinner
Volunteer
and Cancer Survivor Nominations
As stated by its mission, the
American Cancer Society "is the nationwide community-based voluntary
health organization dedicated to eliminating cancer as a major health
problem by preventing cancer, saving lives, and diminishing suffering
from cancer, through research, education, advocacy, and service."
Achieving the American Cancer
Society (ACS) mission depends on the commitment of many individuals
who go unrecognized for their selfless work. On Thursday,
May 22, 2008, the ACS will host its first Appreciation Dinner
in Allen County at the Shawnee Country Club in Lima, Ohio.
This dinner will honor volunteers and cancer survivors and show our
gratitude for their achievement, compassion, courage and inspiration
in advancing the cause of the ACS. One volunteer and one
cancer survivor who exemplify exceptional commitment of service and
achievement will receive a special award.
We are currently accepting
nominations for these awards. Please consider the following criteria
in determining whether a particular person is eligible for nomination:
Eligibility
Criteria for Volunteer
Outstanding commitment
to the ACS mission with at least one year ACS volunteer
service
Devoted time and
initiative to volunteer service in Allen County
Volunteer achievement
represents service without pay
Eligibility Criteria
for Cancer Survivor
Individual living
with the diagnosis of cancer
Provides hope, inspiration
and encouragement to cancer patients and others in the
community
Demonstrated community
involvement and valuable service in Allen County
Please use the following form(s)
to submit your nomination(s). The nominations will be reviewed
by a panel consisting of ACS and Allen County-based healthcare and business
representatives.
Submission
Deadline: Friday,
April 11, 2008
Submit
completed nomination forms to:
Jessica
Stewart
Regional Community Director
American Cancer Society- Northwest Region
740
Commerce Drive, Suite B
Perrysburg, OH 43551
Nominations
may also be e-mailed to jessica.stewart@cancer.org or faxed to 877-227-2838
with a cover page addressed to Jessica Stewart.
To
request an e-mail version of the nomination forms, or if you have any
questions, contact Jessica Stewart by phone at 888-227-6446, ext. 5300,
or via e-mail at jessica.stewart@cancer.org.
2008 American
Cancer Society Allen County Appreciation Dinner
Volunteer
Nomination Form
Nominee: (American Cancer
Society volunteer you are nominating)
Name ___________________________________
E-Mail Address ___________________
Daytime Telephone______________________
Evening Telephone ___________________
Address _______________________________
City/State/ZIP _______________________
American Cancer Society
(ACS) Activities: Describe the ACS activities in which this
volunteer is involved. Include the number of years of service.
(you may attach one additional sheet to this form if needed)
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Please type answers to
the following questions on one sheet of 8 ½ x 11 inch paper.
1.
Why does this volunteer deserve to be honored by the ACS? How
has this volunteer advanced the mission of the ACS in Allen County,
including
preventing cancer/saving
lives
diminishing suffering/helping
others to cope with cancer
2.
In what ways is this volunteer's service to the ACS exceptional or
inspiring? Consider challenges he or she has overcome and results
achieved.
3.
Describe other volunteer service and accomplishments of the nominee
in Allen County. How has he/she enhanced quality of life
and changed the community for the better?
References:
Please provide two letters of reference which support this nominee's
service and accomplishments. References may include one
family member.
Nominator: (Your Name)
Name _________________________________
E-Mail Address ___________________
Daytime Telephone______________________
Evening Telephone ___________________
Address _______________________________
City/State/ZIP _______________________
Signature ___________________________
2008 American Cancer Society
Allen County Appreciation Dinner
Cancer Survivor
Nomination Form
Nominee: (cancer survivor
you are nominating)
Name ___________________________________
E-Mail Address ___________________
Daytime Telephone______________________
Evening Telephone ___________________
Address _______________________________
City/State/ZIP _______________________
Nominee's Cancer Journey:
Briefly describe this survivor's cancer journey, including date of
cancer diagnosis. (you may attach one additional sheet
to this form if needed) _________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Please type answers to
the following questions on one sheet of 8 ½ x 11 inch paper.
1.
Why does this survivor deserve to be honored by the ACS? How has
he/she changed the Allen County community for the better?
2.
In what ways is this survivor's service & accomplishments exceptional
or inspiring? Consider challenges he or she has overcome
and results achieved.
3. How has this survivor advanced the mission of the ACS
in Allen County? Consider how this person has impacted or
touched the lives of cancer patients and others in the community.
References:
Please provide two letters of reference which support this nominee's
service and accomplishments. References may include one
family member.
Nominator: (Your Name)
Name _________________________________
E-Mail Address ___________________
Daytime Telephone______________________
Evening Telephone ___________________
Address _______________________________
City/State/ZIP _______________________
Signature ___________________________
Allen County American Cancer Society
2008 American
Cancer Society Allen County Appreciation Dinner
Volunteer
and Cancer Survivor Nominations
As stated by its mission, the
American Cancer Society "is the nationwide community-based voluntary
health organization dedicated to eliminating cancer as a major health
problem by preventing cancer, saving lives, and diminishing suffering
from cancer, through research, education, advocacy, and service."
Achieving the American Cancer
Society (ACS) mission depends on the commitment of many individuals
who go unrecognized for their selfless work. On Thursday,
May 22, 2008, the ACS will host its first Appreciation Dinner
in Allen County at the Shawnee Country Club in Lima, Ohio.
This dinner will honor volunteers and cancer survivors and show our
gratitude for their achievement, compassion, courage and inspiration
in advancing the cause of the ACS. One volunteer and one
cancer survivor who exemplify exceptional commitment of service and
achievement will receive a special award.
We are currently accepting
nominations for these awards. Please consider the following criteria
in determining whether a particular person is eligible for nomination:
Eligibility
Criteria for Volunteer
Outstanding commitment
to the ACS mission with at least one year ACS volunteer
service
Devoted time and
initiative to volunteer service in Allen County
Volunteer achievement
represents service without pay
Eligibility Criteria
for Cancer Survivor
Individual living
with the diagnosis of cancer
Provides hope, inspiration
and encouragement to cancer patients and others in the
community
Demonstrated community
involvement and valuable service in Allen County
Please use the following form(s)
to submit your nomination(s). The nominations will be reviewed
by a panel consisting of ACS and Allen County-based healthcare and business
representatives.
Submission
Deadline: Friday,
April 11, 2008
Submit
completed nomination forms to:
Jessica
Stewart
Regional Community Director
American Cancer Society- Northwest Region
740
Commerce Drive, Suite B
Perrysburg, OH 43551
Nominations
may also be e-mailed to jessica.stewart@cancer.org or faxed to 877-227-2838
with a cover page addressed to Jessica Stewart.
To
request an e-mail version of the nomination forms, or if you have any
questions, contact Jessica Stewart by phone at 888-227-6446, ext. 5300,
or via e-mail at jessica.stewart@cancer.org.
2008 American
Cancer Society Allen County Appreciation Dinner
Volunteer
Nomination Form
Nominee: (American Cancer
Society volunteer you are nominating)
Name ___________________________________
E-Mail Address ___________________
Daytime Telephone______________________
Evening Telephone ___________________
Address _______________________________
City/State/ZIP _______________________
American Cancer Society
(ACS) Activities: Describe the ACS activities in which this
volunteer is involved. Include the number of years of service.
(you may attach one additional sheet to this form if needed)
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Please type answers to
the following questions on one sheet of 8 ½ x 11 inch paper.
1.
Why does this volunteer deserve to be honored by the ACS? How
has this volunteer advanced the mission of the ACS in Allen County,
including
preventing cancer/saving
lives
diminishing suffering/helping
others to cope with cancer
2.
In what ways is this volunteer's service to the ACS exceptional or
inspiring? Consider challenges he or she has overcome and results
achieved.
3.
Describe other volunteer service and accomplishments of the nominee
in Allen County. How has he/she enhanced quality of life
and changed the community for the better?
References:
Please provide two letters of reference which support this nominee's
service and accomplishments. References may include one
family member.
Nominator: (Your Name)
Name _________________________________
E-Mail Address ___________________
Daytime Telephone______________________
Evening Telephone ___________________
Address _______________________________
City/State/ZIP _______________________
Signature ___________________________
2008 American Cancer Society
Allen County Appreciation Dinner
Cancer Survivor
Nomination Form
Nominee: (cancer survivor
you are nominating)
Name ___________________________________
E-Mail Address ___________________
Daytime Telephone______________________
Evening Telephone ___________________
Address _______________________________
City/State/ZIP _______________________
Nominee's Cancer Journey:
Briefly describe this survivor's cancer journey, including date of
cancer diagnosis. (you may attach one additional sheet
to this form if needed) _________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Please type answers to
the following questions on one sheet of 8 ½ x 11 inch paper.
1.
Why does this survivor deserve to be honored by the ACS? How has
he/she changed the Allen County community for the better?
2.
In what ways is this survivor's service & accomplishments exceptional
or inspiring? Consider challenges he or she has overcome
and results achieved.
3. How has this survivor advanced the mission of the ACS
in Allen County? Consider how this person has impacted or
touched the lives of cancer patients and others in the community.
References:
Please provide two letters of reference which support this nominee's
service and accomplishments. References may include one
family member.
Nominator: (Your Name)
Name _________________________________
E-Mail Address ___________________
Daytime Telephone______________________
Evening Telephone ___________________
Address _______________________________
City/State/ZIP _______________________
Signature ___________________________