Carbon Valley Rotary Club
Service Above Self

Serving the Colorado Communities of
Firestone, Frederick and Dacono

Chartered January 24, 2006
Club No. C000071794

Carbon Valley Rotary
P. O. Box 828
Frederick, Colorado
80530-0828

Community Awards

We would like to recognize outstanding citizens within the Carbon Valley community who are willing to donate their time and effort toward either a specific community project (service award) or who continue to aid the community on an ongoing basis (volunteer award). There is no age discrimination where help is needed and Rotary wants to recognize both youths and adults for the good they do.

We encourage you to nominate the person of your choice for outstanding service and performance within the Carbon Valley community by either completing the online nomination form(s) below or download the printable version in PDF format and mail it to the Carbon Valley Rotary Club. Entries must be received by December 10, 2007 and winners will be recognized in early 2008 for their achievement.

Nomination for Service to Community Award
(All fields are required)

Youth Category (or click here for printable version) Age 17 yrs and younger
Name of Nominee:
How can nominee be contacted:

Person making nomination:
Daytime for phone number :
Email address:

Provide details about the service to community that the nominee has performed. Be as specific as possible within a limit of 1,000 characters.

Adult Category (or click here for printable version) Age 18 yrs and older
Name of Nominee:
How can nominee be contacted:

Person making nomination:
Daytime for phone number :
Email address:

Provide details about the service to community that the nominee has performed. Be as specific as possible within a limit of 1,000 characters.

Nomination for Volunteerism Award
(All fields are required)

Youth Category (or click here for printable version) Age 17 yrs and younger
Name of Nominee:
How can nominee be contacted:

Person making nomination:
Daytime for phone number :
Email address:

Provide details about the service to community that the nominee has performed. This should be ongoing effort that has covered periods of time beyond work on an individual, short term project. Be as specific as possible within a limit of 1,000 characters.

Adult Category (or click here for printable version) Age 18 yrs and older
Name of Nominee:
How can nominee be contacted:

Person making nomination:
Daytime for phone number :
Email address:

Provide details about the service to community that the nominee has performed. This should be ongoing effort that has covered periods of time beyond work on an individual, short term project. Be as specific as possible within a limit of 1,000 characters.

If you have any questions, please email us. Remember, entries are due no later than December 10, 2007.

Thank you for making Carbon Valley a better place!

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