NACUSAC Golden Service Award Nomination Form

NACUSAC Golden Service Award
Nomination Form
Deadline Extended: Friday, June 5, 2015
Eligibility: Nominee’s credit union must be an active member of NACUSAC and they must currently
serve on the credit union’s supervisory/auditing committee. A nomination statement in the form of a
letter must accompany this form. The statement should include a description of why the volunteer is
being nominated including specific details of their service and contribution to their credit union, length
of service, etc.
NOMINEE’S INFORMATION
Name: _________________________________________________________________________
CU Title: _________________________________________________________________________
Credit Union: __________________________________________________________________ __
CU Address/City/State: _____________________________________________________________
Nominee’s E-mail Address:_______________________________________________________________
PERSON SUBMITTING THIS NOMINATION:
Name:___________________________________________________________________________
CU Title: __________________________________________________________________________
E-mail Address: ____________________________________________________________________
Direct Phone: _____________________________________________________________________
Guidelines for Submitting Golden Service Award Nominations:
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Submission deadline for nominations is Friday, June 5, 2015.
Nominations may be submitted by a current NACUSAC member credit union only
Only one nomination per credit union is permitted.
This form must be accompanied by a nomination statement of no more than one page providing
specific examples of the nominee’s service and how it has impacted their committee and credit
union in a positive manner.
 Nominations can be submitted by email to celeste@nacusac.org; or by fax to (858) 792-3884.
 The nominating credit union will be notified if their supervisory/audit committee volunteer is
selected to receive the award.
 The award recipient will be honored at a special luncheon during NACUSAC’s Annual
Conference, on June 19, 2015.