Community Service - Ebby Halliday Award Response Form

Candidate Details

Candidate's Name*

First Last

Email*

Phone*

Contact Name/Telephone to Contact if Selected as Award Winner (VERY IMPORTANT)*

Professional Details

Length of Service in Chosen Profession*

Firm Name*

Number of Years With Firm*

Current Position in Firm*

Firm Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Community Organization

Community Organization Name*

Is the Organization a 501(c)(3)*

Yes

No

Phone*

Email*

Website

Community Organization Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Organization Details

What does the organization do?*

Briefly describe the organization’s mission and the people it serves.

What do you do for the organization?*

Briefly describe the nature of the your volunteer work (e.g. founder, fund raiser, leader, event planner, etc.

How long have you been volunteering with this organization?*

Personal Contribution*

Nominees should have made a significant contribution of personal time, but contributions of money, materials, or other resources will be considered by the selection committee. This information is required. Although you may not keep exact records of your contribution, we must have your best estimate in order to evaluate the entry.

Compensation

Are you compensated for any portion of the community service work described in this application?*

Yes

No

If yes, please explain.

Employment

Do you perform the community service as part of your duties as an employee or corporate officer of a real estate company?*

Yes

No

If yes, please explain.

Personal Statement

In no more than 500 words, describe how your individual efforts have made the community a better place to live.*

Please include which committee, position held years, and accomplishments.

Uploads

Please upload a current headshot.*

Max. file size: 256 MB.

If you need more room than has been provided for any of the above items, please submit any additional documentation for the selection committee. If desired, you can also include a current resume.

Drop files here or