MNWT Women Who Impact Award Nomination
For the Lois M Christensen Women Who Impact Award, a chapter may submit multiple nominees in each of the different areas: Youth Outreach, Women’s Advocacy, Non-Profit. However, a separate nomination form must be submitted by November 1 for each nominee along with a $25 nomination fee each.

NOTE: this form requires two (2) signatures: one from the Nominee and one from the nominator. Be sure to have all signatory representatives present when completing this form. Signatures can be done by your mouse, or your finger on a writable screen.

Use the File Upload field found at the bottom to include the required attachments.

Responses to the online form will be viewed by the MNWT Winter State Awards Chair by due date. Upon completion of the form, click Submit; you will receive a confirmation screen if your form has been successfully submitted. (rev 2019)
  • Nominator Information

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  • By signing your name, you attest that all facts contained in this form and the resume are true and therefore give my permission for these facts to
    be published..
  • Local Newspaper

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  • Nominee Information

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  • Include ages if known of each child.
  • By signing your name, you attest that all facts contained in this form and the resume are true and therefore give my permission for these facts to
    be published..
  • Nomination Requirements

    • Submission deadline is November 1.

    • A complete submission includes: Nomination Information Sheet, Women Who Impact Award Resume, three letters (one from the nominee, one from the chapter and one letter of support from outside the chapter/letter of recommendation) and a $25 nomination fee.

    • Follow the Entry Resume format shown below or standard outline format. Entry Resumes must be typed. Times New Roman type (10 point) or Calibri type (10 point) are the smallest font size allowed. Keep the entry neat and readable, using appropriate grammar and spelling and writing in complete sentences.

    • Type “Women Who Impact Award Entry Resume” top of the first page along with the area of the nomination (Youth Outreach, Women’s Advocacy, Non-Profit). Type the nominee’s name directly under this heading on the first page and at the top of each consecutive page of the resume. Entry Resume should be written in the third person format (he/she).

    • Entry Resume is not to exceed three (3) pages. Number pages in the lower right corner. Reduced copies are not allowed. Other materials such as pictures, newspaper articles, etc. are not to be included.

    • Be specific and complete, using details. Emphasize personal initiative shown by the nominee rather than just general involvement. Be specific on new ideas and programs the nominee has promoted and started.
  • Entry Resume Format

    Lois M Christensen Women Who Impact Award Entry Resume
    [Area of Nomination]
    [Nominee’s Name]

    Participation in Activities and Contributions to the Welfare of Others.
    • Attends City Council meetings and serves as an active member of the Parks Improvement Committee.
    • Volunteer leader for the local Girl Scouts.

    Exhibition of Leadership Ability, Personal Development and Initiative.
    • Led the Parks Improvement Committee for two years and secured a $200,000 Parks Improvement Grant.
    • Began a Girl Scout After-school Book Club about famous women.

    Overall Effects of Contributions and Evidence of Lasting Effects of Contributions.
    • The City has begun park improvements that include the planting of 100 new trees and new playground construction.
    • The After-school Book Club began with one group of six girls and has now expanded to five groups and includes fifty girls. With (Nominee’s) assistance an After-School Book Club has begun in two neighboring communities.

    List Any Activities, Additions or Awards You Would Like to Include
    • Because of (Nominee’s) involvement on the Parks Improvement Committee, she has begun work with the local elementary school to secure a grant for new playground equipment and supplies.
    • (Nominee) has become a representative on the regional board of Girl Scouts.

    Additional comments by the nominator.