Women of Distinction 2013

2013 Women of Distinction form for Denver & Pikes Peak

Please return by March 22, 2013 for Pikes Peak.

Thank you for helping to identify outstanding women from our community. Candidates for the honor of being named Women of Distinction or Women to Watch exemplify the Girl Scout Leadership Experience and serve as models of inspiration to Girl Scouts, other Women of Distinction and all those who value the mission of Girl Scouts of Colorado.

A nominee should:
• be a recognized and respected leader in her field of expertise and in the community
• have a proven track record of community service/volunteerism
• demonstrate commitment to girls’ and women’s issues
• be willing to participate in Women of Distinction activities with girls, and attend annual functions, including the Women of Distinction Dinners, on an on-going basis
• be open to supporting Girl Scouts of Colorado through service, networking and/or financial commitment

Nominator Name

Title

First

Middle

Last

Suffix

Nominator Work Phone

Area Code

Phone Number

Nominator Home Phone

Area Code

Phone Number

Nominator Address

Street Address

Apt./Ste.

City

State

Postal Code

Nominator Email

Nomination is for:

Woman of Distinction Pikes Peak

Woman to Watch (Pikes Peak Candidates Under 40 years of age)

Please Include a copy of your Nominee's resume or vitae.

Nominator's relationship to Nominee

Name of Nominee

Title

First

Middle

Last

Suffix

Nominee Home Telephone

Area Code

Phone Number

Nominee Home Email

Nominee Home Address

Street Address

Apt./Ste.

City

State

Postal Code

Nominee Business Name

Nominee Title (if applicable)

Nominee Business Address

Street Address

Apt./Ste.

City

State

Postal Code

Nominee Business Telephone

Area Code

Phone Number

Nominee Business Email

While the focus of the 2013 Thin Mint Dinner will be a celebration of Live Healthy, Lead Healthy’s first year of engagement with girls, qualified nominees will be selected from a variety of backgrounds and expertise that Girl Scouts of Colorado would like to recognize in 2013. Please indicate which of these categories best describes your nominee.

You may indicate more than one category, if applicable

Corporate leader/Entrepreneurship

Health and Wellness

Sports

STEAM (Science, Technology, Engineering, Arts and Math)

Education

Law

Non-Profit

Girl Scout Volunteer Leadership

Please provide information not included on the resume or vitae about the Nominee.

Name of Organization

Volunteer Position(s)

Name of Organization

Volunteer Position(s)

Name of Organization

Volunteer Position(s)

Please list any awards or recognition not listed on the resume or vitae.

Please indicate if, to your knowledge, the Nominee was a Girl Scout

yes

What distinguishes this nominee as a leader in her field and/or a woman who has demonstrated outstanding commitment to girls’ and women’s issues and community service?

What in your estimation will make this nominee an effective advocate for Girl Scouts and its mission to build girls of courage, confidence and character?

Thank you for your nomination.

Please return to:

Karen Burghart
Girl Scouts of Colorado
3535 Parkmoor Village Drive
Colorado Springs, CO 80917
719-597-5896 fax
karen.burghart@gscolorado.org