2023 Nominee InformationName (as you wish to see in print/digital/etc.)*FirstLastEmail Address (will not be disclosed)*Telephone Number (will not be disclosed)*Name of Employerif self employed, list name of company/organizationEmployer Address (will not be disclosed)Employer CityEmployer StatePlease selectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingEmployer ZipEmployer Telephone (will not be disclosed)Your Job TitleVolunteer Information Please list organizations where you currently or previously serve/served as a volunteer. We also request the approximate dates of volunteer services such as 1999-present or 1999-2005, etc. List the positions you held as a volunteer. Some positions might be described as board chair, vice chair, program chair, etc. The application does not include an exclusive list of volunteer positions and are listed, only as suggested positions. To add volunteer information, click the “down-arrow” on the number of organizations. Once you identify the number of organizations, the appropriate number of templates will appear.Number of Organizations*Please select123456789101112131415Organization OneOrganization Name & City*If multiple locations, list HQ or primary SF Valley locationVolunteer Dates of Service*Position(s) Held*Please selectBoard officer such as chair, vice chair, secretaryBoard memberBoard ex-officioProgram chair, co-chair, program committee memberCommittee chair, committee memberSpecial event chair (be specific for which event or events)OtherOrganization TwoOrganization Name & City*If multiple locations, list HQ or primary SF Valley locationVolunteer Dates of Service*Position(s) Held*Please selectBoard officer such as chair, vice chair, secretaryBoard memberBoard ex-officioProgram chair, co-chair, program committee memberCommittee chair, committee memberSpecial event chair (be specific for which event or events)OtherOrganization ThreeOrganization Name & City*If multiple locations, list HQ or primary SF Valley locationVolunteer Dates of Service*Position(s) Held*Please selectBoard officer such as chair, vice chair, secretaryBoard memberBoard ex-officioProgram chair, co-chair, program committee memberCommittee chair, committee memberSpecial event chair (be specific for which event or events)OtherOrganization FourOrganization Name & City*If multiple locations, list HQ or primary SF Valley locationVolunteer Dates of Service*Position(s) Held*Please selectBoard officer such as chair, vice chair, secretaryBoard memberBoard ex-officioProgram chair, co-chair, program committee memberCommittee chair, committee memberSpecial event chair (be specific for which event or events)OtherOrganization FiveOrganization Name & City*If multiple locations, list HQ or primary SF Valley locationVolunteer Dates of Service*Position(s) Held*Please selectBoard officer such as chair, vice chair, secretaryBoard memberBoard ex-officioProgram chair, co-chair, program committee memberCommittee chair, committee memberSpecial event chair (be specific for which event or events)OtherOrganization SixOrganization Name & City*If multiple locations, list HQ or primary SF Valley locationVolunteer Dates of Service*Position(s) Held*Please selectBoard officer such as chair, vice chair, secretaryBoard memberBoard ex-officioProgram chair, co-chair, program committee memberCommittee chair, committee memberSpecial event chair (be specific for which event or events)OtherOrganization SevenOrganization Name & City*If multiple locations, list HQ or primary SF Valley locationVolunteer Dates of Service*Position(s) Held*Please selectBoard officer such as chair, vice chair, secretaryBoard memberBoard ex-officioProgram chair, co-chair, program committee memberCommittee chair, committee memberSpecial event chair (be specific for which event or events)OtherOrganization EightOrganization Name & City*If multiple locations, list HQ or primary SF Valley locationVolunteer Dates of Service*Position(s) Held*Please selectBoard officer such as chair, vice chair, secretaryBoard memberBoard ex-officioProgram chair, co-chair, program committee memberCommittee chair, committee memberSpecial event chair (be specific for which event or events)OtherOrganization NineOrganization Name & City*If multiple locations, list HQ or primary SF Valley locationVolunteer Dates of Service*Position(s) Held*Please selectBoard officer such as chair, vice chair, secretaryBoard memberBoard ex-officioProgram chair, co-chair, program committee memberCommittee chair, committee memberSpecial event chair (be specific for which event or events)OtherOrganization TenOrganization Name & City*If multiple locations, list HQ or primary SF Valley locationVolunteer Dates of Service*Position(s) Held*Please selectBoard officer such as chair, vice chair, secretaryBoard memberBoard ex-officioProgram chair, co-chair, program committee memberCommittee chair, committee memberSpecial event chair (be specific for which event or events)OtherOrganization ElevenOrganization Name & City*If multiple locations, list HQ or primary SF Valley locationVolunteer Dates of Service*Position(s) Held*Please selectBoard officer such as chair, vice chair, secretaryBoard memberBoard ex-officioProgram chair, co-chair, program committee memberCommittee chair, committee memberSpecial event chair (be specific for which event or events)OtherOrganization TwelveOrganization Name & City*If multiple locations, list HQ or primary SF Valley locationVolunteer Dates of Service*Position(s) Held*Please selectBoard officer such as chair, vice chair, secretaryBoard memberBoard ex-officioProgram chair, co-chair, program committee memberCommittee chair, committee memberSpecial event chair (be specific for which event or events)OtherOrganization ThirteenOrganization Name & City*If multiple locations, list HQ or primary SF Valley locationVolunteer Dates of Service*Position(s) Held*Please selectBoard officer such as chair, vice chair, secretaryBoard memberBoard ex-officioProgram chair, co-chair, program committee memberCommittee chair, committee memberSpecial event chair (be specific for which event or events)OtherOrganization FourteenOrganization Name & City*If multiple locations, list HQ or primary SF Valley locationVolunteer Dates of Service*Position(s) Held*Please selectBoard officer such as chair, vice chair, secretaryBoard memberBoard ex-officioProgram chair, co-chair, program committee memberCommittee chair, committee memberSpecial event chair (be specific for which event or events)OtherOrganization FifteenOrganization Name & City*If multiple locations, list HQ or primary SF Valley locationVolunteer Dates of Service*Position(s) Held*Please selectBoard officer such as chair, vice chair, secretaryBoard memberBoard ex-officioProgram chair, co-chair, program committee memberCommittee chair, committee memberSpecial event chair (be specific for which event or events)OtherNominee Questions The responses to the following questions are to help the Fernando Finalist Selection Committee better understand you, as a Fernando nominee. Please answer each question (750 characters, maximum).Why do you volunteer in the community?*(750 characters max)How did you get started in volunteer service? *(750 characters max)What are your specific goals for the future as you continue volunteering?*(750 characters max)File UploadsPhoto Upload*Recent, high resolution headshot, in colorBiographical Resumé Upload (two pages maximum)*Maximum two-page professional bio-sketch or resume.AttestationBy checking this box, I hereby attest that all information provided on this form is accurate and truePlease type the characters*Typing in these characters helps us prevent unauthorized use of this online nomination form. Thank you.SubmitThis field should be left blank