DISTINGUISHED SERVICE AWARD NOMINATION FORM

DISTINGUISHED SERVICE AWARD NOMINATION FORM

Recommended Award:

_____ Service to NASCOE

_____ Service to FSA-Agriculture

_____ Community Service

State: ________________________________________________

Area: ________________________________________________

Award Nominee Name: ___________________________________________________

Home Address:____________________________________________________

Telephone: ____________________________________________

Office Address: ____________________________________________________

Telephone: ____________________________________________

Email: __________________________________________________________

FSA Position Held:_________________________________________________

Person submitting Nomination: ____________________________________________

Address: _________________________________________________________

Home Telephone: _______________________________________

Office Telephone: _______________________________________

Email: ___________________________________________________________

Brief Explanation: (see instructions)

________________________________________________________________________

________________________________________________________________________________________________________________________________________________

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INSTRUCTIONS

A nomination should be brief, factual, and specific! The use of general terms, adjectives, superlatives, and conclusions not hacked by facts should be avoided. Specific examples and details should be given to support the nomination.

Some recommended items to be included in each of the three categories for a DSA nomination are listed below. However, any other pertinent information can also be included.

SERVICE TO NASCOE: Years of NASCOE membership; committee activity; offices held; contributions to the organization; FSA background.

SERVICE TO FSA-AGRICULTURE: How long has nominee worked for FSA?; what program or special project have they worked with?; size of county and number of farmers; any outstanding contribution to FSA and/or Agriculture?; has nominee received any special awards or promotions?; NASCOE background.

COMMUNITY SERVICE: What organization(s) has nominee worked with?; do they hold an office or any special committee assignment?; their church affiliation, family status, children, etc.; what has nominee done to improve the community he/she lives in?; any special recognition received?; FSA and NASCOE background.