Hon Kachina Awards Online Nomination form

Please read the guidelines before submitting your nomination. Thank You.

You can also download the nomination form in a PDF format.

PLEASE NOTE: The Hon Kachina Volunteer Award nomination form has recently been updated. Although there are more questions, please answer each question very briefly. You will be able to elaborate on your answers when a member of the Hon Kachina Council contacts you to discuss your nominee. When completing your application, you may want to prepare your responses in a Word document and paste them into the form once complete. AND . . . you may also choose to print your completed form before you submit it, so you have a copy of it on hand.

All data on this page is required for your nomination to be accepted.

Nominee Information


Nominee's Name (required):

Age (required):

Address (required):

City (required):

State (required):

Zip Code (required):

Employer (required):

Position (required):

Business Address (required):

City (required):

State (required):

Zip Code (required):

Telephone

Home: (required):

Work (required):

Fax:

E-mail Address (required):



Nominator Information


Nominator's Name (required):

Title (required):

Business Name - Organization (required):

Address (required):

City (required):

State (required):

Zip Code (required):

Telephone

Home: (required):

Work (required):

Fax:

E-mail Address (required):

Relationship to Nominee (required):

How did you learn about the Hon Kachina Volunteer Awards Program? (required):



Other:



Please Answer These Questions:


How long have you known the nominee? (required):

Why did you nominate this nominee? (required):

Name the organization(s) with which the nominee has volunteered? (required):

How many years has this nominee been involved in the organization(s) mentioned above? (required):

How many hours per month does this nominee volunteer with the organization(s) mentioned above? Per year? (required):

Explain the specific nature of the volunteer work? (required):

Explain how many people/groups has the nominee impacted? (required):

Explain any lasting impact due to the nominee’s volunteer work? (required):

Explain how the nominee has motivated or recruited others to volunteer? (required):

Explain any innovation this nominee has demonstrated (leadership, development of program, etc.)? (required):

How has this nominee demonstrated leadership in his/her volunteer work? (required):

List specific volunteer leadership positions held by the nominee? (required):

Is this nominee compensated for his/her volunteer work? (required):

What motivates this nominee to volunteer? (required):

Why does this nominee continue to volunteer? (required):

Why is this nominee a unique volunteer? (required):

Does this nominee work full or part time? If yes, where and how many hours worked? (required):

Describe any special challenges (physical, time or financial) this nominee has had to overcome to perform his/her volunteer service? (required):

Summarize why this nominee deserves the Hon Kachina Volunteer Award? (required):



In order to qualify, a nominee must have three (3) references who may be contacted to verify the scope and extent of the nominee's activities. References should be people familiar with the nominee's community service activity and should not include the nominee or any person related to the nominee.

1st Reference Name (required):

Phone (required):

E-mail Address (required):

Relationship to Nominee (required):



2nd Reference Name (required):

Phone (required):

E-mail Address (required):

Relationship to Nominee (required):



3rd Reference Name (required):

Phone (required):

E-mail Address (required):

Relationship to Nominee (required):

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For additional information, call: (480) 905-1578 or email [email protected]
You will receive an email to confirm your nomination form has been submitted successfully.

Note: If you are unable to submit your nominaton, make sure you've filled out every field. All fields are required.