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Global Alumni Service to Humanity Award

The Rotary Foundation

GLOBAL ALUMNI SERVICE TO HUMANITY AWARD

The Rotary Foundation Global Alumni Service to Humanity Award was created to honor an outstanding former Foundation program recipient whose extraordinary service to humanity and professional achievements exemplify the Rotary ideal of Service Above Self.

Candidate must have completed his or her Foundation program participation prior to 1 July 1995.

Districts may nominate one candidate for this award. Candidate may have been sponsored by any Rotary club or district.

All Rotary Foundation alumni are eligible for the award: former Ambassadorial Scholars, Group Study Exchange team leaders and members, and recipients of a Grant for rotary Volunteers, University Teacher Grant, or Discovery Grant.

Candidate must have provided outstanding service to humanity and must have achieved the highest degree of distinction in his or her profession or vocation.

Candidate must have served as a global citizen impacting the international scene (i.e., his or her activities should extend well beyond the local or community level).

The award is open to both Rotarians and non-Rotarians. Only one award will be given to a single individual in any year.

In the space below and on the other side of this form please type or print legibly the answers to the following questions.

Name of Candidate                                                                                                □Male        □Female

Address                                                                                                                                                 

City                                                                                                                                                       

State/Province, Postal Code, Country                                                                                                       

Telephone                                                                                       Fax                                                 

E-mail                                                                                                                                                    

Foundation Program                                                                                                                                

Sponsor District (if known)                                Host District (if known)                                                     

Sponsor rotary Club (if known)                                                                                                               

Nominator’s Name                                                                                                                                  

Address                                                                                                                                                    

City                                                                                                                                                          

State/Province, Postal Code, Country                                                                                                      

Telephone                                                                               Fax                                                           

E-mail                                                                                                                                                     

Nominating District                                        District Governor (please print)                                           

                                                                        District Governor’s Signature                                          

(continued on reverse side)
　

CANDIDATE INFORMATION

1. Candidate’s profession or vocation:

2. Candidate’s current position or title:

3. Professional awards or honors the candidate has received:

4. Rotary service and awards (if applicable):

5. On a separate sheet, please describe the candidate’s humanitarian service activities and why this candidate should be considered for this award.

A complete application will include:

□ This nomination form, signed by the current district governor

□     Resume or curriculum vitae

□     Description of candidate’s service to humanity (point 5 above)

□     A digital or print photograph of the candidate

THE DEADLINE FOR NOMINATIONS IS SET BY INDIVIDUAL ZONE COMMITTEES.

All nominations should be submitted to your zone alumni Award committee:

Additional copies of this nomination form are available from the Alumni Relations Section or may be downloaded from the RI Web site: www.rotary.org