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Rotarian Of The Year Award Nomination Form

The Rotarian of the Year award recognizes a Rotarian who has made a significant impact in supporting and strengthening the Rotary Club of Green Bay. Read this form carefully. Nominations must be submitted on this form and may not exceed the space provided. Handwritten forms will not be accepted.

Nominations must be received by May 25, 2018. Nominations received after the deadline will not be considered.

Any active member of the Rotary Club of Green Bay is eligible.

Please use one of the options below to send in your Rotarian Of The Year Award Nomination Form:

  1. Download Word File Here and Email to
  2. Or Submit an Online Form By Clicking the Button Below
Submitter Information
Submitter Title(*)
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Submitter First and Last Name(*)
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Submitter Phone Number(*)
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Submitter Email Address(*)
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Nominee Information
Full name of the Nominee(*)
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To qualify, the nominee must demonstrate a broad range of service over a period of time, and must include the following accomplishments, with substantial activity in the past three years.

1. During the year of nomination, participated in at least one meaningful club-level service project. Describe:

Item 1(*)
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2. Attended at least one district meeting in the three years immediately preceding ear of nomination. Describe:

Item 2(*)
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3. During the year of nomination, supported Rotary’s service work by contributing to both the Rotary Local and International Foundations.

Item 3(*)
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4. Carries the spirit of Rotary into the community. Describe:

Item 4(*)
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5. During the year of nomination, maintained attendance of at least 60%.

Item 5(*)
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6. Made other significant contributions to our Rotary Club during the year of nomination. Describe:

Item 6(*)
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Just making sure you are not a robot(*)
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Submit Rotarian Of The Year Award Nomination Form