United Way DOC Form

Volunteer of the Month Nomination Form

Please send this form or copy of to:

Volunteer Connection Coordinator
United Way for the Wabash Valley
P O Box 3094
Terre Haute, IN 47803
Fax: 812-235-3901
Email to: joan.kutlu@unitedway.org

Here is your chance to nominate the volunteer of your choice who deserves the recognition for their contributions to our community!

The Volunteer of the Month article is featured in the Terre Haute Tribune Star the last Sunday of each month

Your name

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Date

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Agency/Organization

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Your affiliation with the above Agency/Organization

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Your relationship to the nominated volunteer

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Phone number [where you may be reached]

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Name of volunteer you wish to nominate

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Address and phone [of volunteer]

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Brief description of volunteer’s involvement
(If you need more space, please use another sheet of paper and attach to form)

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