Golden Years Service Awards

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					GOLDEN YEARS GALA SERVICE AWARDS
      To be given to Clay County senior adults 60 years or older

                          Award Categories

 o Advocacy – effectively promotes causes for the good of others
 o Arts – promotes or contributes to the area of visual or performing arts
 o Business – contributes to the further growth of business
 o Education – contributes to the lives of our citizens through teaching,
                 administration, or other involvement in educational programs
 o Faith-based –contributes to the community through spiritual leadership
                   and direct involvement in faith-based programs
 o Health – contributes to the physical and/or mental well being of citizens in
            the community
 o Legal – provides legal-related service to others
 o Social Services – improves the quality of life for citizens of Clay County
                     through attention to such basic needs as food, housing,
                     transportation, and recreation.


                                Tell Us Why

Senior adults give their time and talents in many areas of service to our
community. Please tell us why the person you nominate (the nominee)
should be selected to receive a recognition award in one of the categories
listed above. Please check the category you have selected. Award
decisions will be based upon the information you provide so be as detailed
as possible.




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                     Nomination Guidelines

    Nomination forms must be received by January 31, 2010 to be
    considered. The nominee must be a resident of Clay County and
    be at least 60 years of age. Nominated individual must have
    made significant contributions to the community in the category
    selected during 2009. Nominations forms must be completed in
    full with all required information to be eligible for consideration.




                    Nomination Submitted by:

Name:                                                         .
Title:                                                         .
Company:                                                      .
Phone Number:                                                 .
E-mail Address:                                               .
Relationship to Nominee:                                      .

                      Nominee Information:
Nominee’s Name:                                                            .
Home Address:                                 .   City:                    .
State: FL    Zip:            .
Daytime Phone: ( )                    .Cell Phone: (      )                .
Date of Birth:                            .

 Completed nomination form should be submitted in written or printed
 form to:             Clay County Council on Aging
                        ATTN: Golden Years Awards Nominating Committee
                        604 Walnut Street
                        Green Cove Springs, FL 32043


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                        Reason for Nomination:
Please describe in 100 to 150 words (here or attached) why you have nominated this
individual for the award in the category selected. You must explain how the individual
has demonstrated outstanding service in Clay County during 2009.

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