Volunteer Hall of Fame Nomination Form Fillable PDF

Document Text Version

Established 1989

Nomination materials, including a photo and letter(s) of recommendation, must be postmarked or submitted electronically by January 20, 2023.

Incomplete forms, misdirected mail, or materials received after the deadline will not be considered.

Questions?  E-mail info@volunteeriowa.org or call 800.308.5987


  • Any Iowa individual, national service member (current or alum), family, organization, nonprofit, business, or corporation, actively engaged in voluntary service benefiting the community, state, nation, or world may be nominated.
  • Service may be directed either at domestic or international problem-solving, but should not be part of regular employment duties. National service members may be nominated for outstanding performance of duties that are included as part of their service assignment.
  • Previous Iowa Volunteer Hall of Fame inductees (see list at the end of this document), current employees and Commissioners of Volunteer Iowa, along with current employees of the Governor’s Office are not eligible to receive this award.


  • FOR the nomination to be accepted and reviewed, ALL requested information, including letter(s) of recommendation, must be submitted TOGETHER.
  • Community Needs and Solution — How did the nominee’s actions meet or solve a real community need or challenge? Did the activities lead to a long-term solution? Has the nominee made a long-lasting positive and meaningful difference in the lives of people in the community, region, state, nation, or internationally through volunteer service activities?
  • Connection Building — How did their activities demonstrate hands-on service that resulted in building connections between the community and those who may be isolated from it? Were connections made with groups beyond the agency for which the volunteer worked?
  • Impact — What impact/benefits resulted from the nominee’s activities and efforts? How many or what or types of people and groups were worked with? What was the nominee’s level of involvement? Was the amount of time spent significant?
  • Distinctive Achievements — Was the service provided extraordinary and meaningful? Did the activities completed show innovative or unique approaches to addressing serious social challenges?

Selection Process — A review panel comprised of leaders and experts in volunteerism and community service will evaluate submissions and make selections based on the criteria listed above.

Notification — The people and/or groups selected will receive a congratulatory letter from the Governor’s Office inviting them to accept their award in person; a copy will be sent to the person who submitted the nomination.

Recognition — Awards are presented during a special ceremony in the State Capitol Building. Names of inductees are added to the Iowa Volunteer Hall of Fame plaque on permanent display in the State Historical Museum.

Submission Instructions: It is strongly recommended that nominations first be prepared in a word processing document. Use the following pages to help collect and organize the information so it can be easily copied and pasted into the online form. Not only does this let the nominator collect, write, edit, and check character counts but it also ensures that any disruptions (e.g., loss of Internet connection) do not mean loss of time and work.

One photo of the nominee and minimum of one letter of recommendation should be included with the nomination, but do NOT include CDs, DVDs, newspaper articles, notebooks, or other materials. Late, incomplete or misdirected nomination forms will be disqualified. 

Nominations must be postmarked, submitted online, or e-mailed by January 20, 2023:

Online (preferred method): Link and instructions for the online nomination form can be found at volunteeriowa.org. Attach a .jpg or .png photo.

By e-mail: To info@volunteeriowa.org (MS Word attachment preferred).  Include “ATTN: Hall of Fame” in the subject line. Attach a .jpg or .png photo.

By mail: Volunteer Iowa, ATTN: Volunteer Hall of Fame, 1963 Bell Avenue, Suite 200, Des Moines, IA 50315. Include one photo.

Nomination Form

Iowa Volunteer Hall of Fame

NOMINEE Information

Category (any individual or group actively engaged in voluntary service benefiting the community, state, nation, or world may be nominated) SELECT ONE:

  1. Individual (one person)
  2. Group (two or more members of a family, or representatives of an organization, nonprofit, business, or corporation. Volunteer activities must have been completed together as a team.)

Nominee Name:                                                                                                                                              

EXACTLY as it is to appear on the award plaque if they are selected.

Nominee Mailing Address:

Nominee City, State, Zip Code:                                                                                                                       

Contact Person is required if nomination is for a Group:                                                                                                                     

Contact should NOT be the person submitting the nomination. Leave this field blank if nominating an individual.

Nominee’s County of Residence:                                                                                                                   

Or indicate that nominee is a statewide organization.

Nominee’s Length of Service (number of YEARS this nominee has served). Be specific. It’s acceptable to estimate, but do not use terms like “many” or “countless”:                                         

Nominee’s Daytime Phone Number (include area code):                                                                                 

Nominee’s (or contact person’s) E-mail Address:                                                                                                      

Nomination submitted by



Mailing Address:

City, State, Zip Code:                                                                                                                                      

Daytime Phone Number (include area code):                                                                                                   

E-mail Address:                                                                                                                                              


  1. I hereby certify that the information being submitted is an accurate representation of the service performed by the nominee.

Nominator’s Signature:                                                                                                                                    

Nominator’s typed or printed name:                                                                    Date:                                       

Don’t forget! You need to include a good quality photo with your submission.

Provide brief, but detailed and specific, information to address each of the included essay questions. Every component of each question must be answered; there is a 500-word limit for each section. Use specific examples to illustrate the scope and extent of the nominee’s volunteer activities.


Provide brief but specific information to address each of the essay questions. Every component of each question must be answered. There is a word limit for each question. Use specific examples to illustrate the scope and extent of the nominee’s volunteer activities.

Summary — Provide a brief statement describing the nominee’s history with volunteering, and why they are worthy of being selected for the Iowa Volunteer Hall of Fame. (100 words or fewer)

Community Needs and Solution — Describe how the nominee’s actions met or solved a real community need. Include specific information about how the activities led to a long-term solution. (500 words or fewer) Note: Volunteer Hall of Fame defines "community" broadly as that which benefitted from the nominee's service. Eligible service may occur at local, regional, state, national OR international levels.

Connection Building — Provide examples of how the nominee demonstrated hands-on service to build connections between the community and those who might be isolated from it. Explain if and how activities served those who are disconnected from the larger community. Explain if and how connections were made with groups beyond the agency for which the volunteer worked. (500 words or fewer)

Impact — List or describe the impact and benefits achieved because of the activities and efforts of this nominee (changes in the economy, environment, or social conditions). List or describe examples of the nominee’s impact- e.g. funds raised, volunteers trained or recruited, partners established, programs created, people or communities served. Be as specific as possible. (500 words or fewer)

Service Involvement — Describe the nominee’s level of involvement in the activities and impacts listed in the previous sections. Was the amount of time spent significant? Include examples of how the nominee’s service showed innovation or unique approaches to addressing social challenges. (500 words or fewer)

Additional Recognition — has the nominee received other recognition or awards for their volunteer activities? (i.e., Governor’s Volunteer Award, Daily Point of Light Award, President's Volunteer Service Award, local volunteer award, etc.).   Yes (please explain below)       No       Unknown

PART IV: RE-SUBMISSION OPT-IN. As of 2023, you may elect to automatically re-submit a nomination for up to 2 years in the event that your nominee is not selected. Please indicate if you want to keep this nomination active for future years: Yes    No

PART V: LETTER OF RECOMMENDATION (minimum of one, maximum of three) from someone familiar with the nominee who can verify the scope and extent of their volunteer service activities (letter cannot come from the nominee or a relative). Letters to “Dear Selection Committee,” must include the full name, organization, e-mail address and daytime phone number of the person submitting the letter, and should address the following:

  • How long and in what ways have you known the nominee?
  • Why do you think this nominee is worthy of being selected for the Iowa Volunteer Hall of Fame?
  • What would you like the selection committee to know about this nominee and their efforts that’s not included elsewhere in the nomination form?

Printed from the website on March 30, 2023 at 10:36pm.