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Block 2

2023-24 ROTARY PEOPLE OF ACTION RECOGNITION

Overview
The 2023-24 Rotary People of Action honors will recognize six Rotary members, Peace
Fellows, Global Grant Scholarship recipients, or Rotary alumni, who have had a
leadership role in implementing an impactful project in their communities.

Champions of Impact
Rotary defines impact as “positive, long-term changes on individuals, communities, or
systems that result from Rotary’s actions.” The highlighted Rotary projects will
demonstrate sustained impact of Rotary member actions. While projects could address
any community need, we want to see clear evidence of the change resulting from the
project. Projects that align with President Gordon’s mental health initiative are eligible for
nomination. Honorees will be recognized at the International Convention in Singapore.

Nomination Guidelines

Submission deadline: Friday 17 November

Criteria
Ideal projects or initiatives can/should:
• Relate to one of Rotary’s Areas of Focus
• Be built for sustainability after Rotary’s involvement ends
• Represent Rotary’s ideals and values, reflecting an organizational culture of inclusion
that emphasizes belonging, honesty, openness and willingness to learn.
• Not focus primarily on fundraising or providing material support (i.e., buying laptops,

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books, pads, etc.), though both can be an element of the larger project.
• Be able to answer all of the following:
o What problem or issue does/ did the project address?
o What was the situation before the project intervention – and how were the key
issues identified?
o What is/was the sustained impact the project intended to achieve?
o What tangible or immediate results came from the project such as the number of
people trained, or the number of items distributed?
o What additional short-term results came from the project such as training teachers
using a new methodology or community health workers conducting visits to
households?
o Who ultimately benefited from the project? What was the impact, or effect, on their
lives?
o What kind of data or evidence can you provide to demonstrate this impact?
o How were Rotary members essential to the positive change that resulted as part
of this project? What critical role did they play?
o What could others who undertake similar projects learn from your experience?

As with all People of Action recognitions, project representatives should have taken a
leadership role in implementing “hands on” volunteer activities or initiatives. Ideal
projects should be able to demonstrate /define/ address a specific community need and
serve as examples to inspire other members to learn from such project successes

Individual Eligibility:
Rotary People of Action: Champions of Impact project representatives must:
• Be a Rotary member, Peace Fellows, Global Grant Scholarship recipient, or Rotary
alumni
• Be involved with a project that is currently active or concluded no earlier than June
2022
• Over the age of 18 by the nomination deadline
• Have held a leadership role in the hands-on implementation of the project.
• Self-nominations will not be considered.

Individuals or projects previously recognized with one of the following honors are
ineligible for consideration:
• White House Champions of Change
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• Women of Action
• Rotary’s Global Women of Action
• Rotary’s Responsible Business Award
• Rotary People of Action: Champions of Peace
• Rotary People of Action: Young Innovators
• Rotary People of Action: Connectors Beyond Borders
• Rotary People of Action: Champions of Health
• Rotary People of Action: Champions of Girls’ Empowerment
• Rotary People of Action: Champions of Inclusion
• Rotary Programs of Scale winners

Nomination Process
All Rotarians, Rotaractors and Peace Fellow Alumni will have the opportunity to submit individual
nominations. Nominators will be able to access the nomination forms via Rotary.org or on social
media.

All submissions will be reviewed by at least two readers. A special panel appointed by the
Rotary International President will review the semi-final nominations and select six finalists and
two alternates for the President's final selection of six honorees.
Honorees will be notified of their selection in by 15 January 2024.

Block 3

Completing the Nomination

Complete the nomination form

A preview version of the form can be downloaded by clicking this link:
Champions of Impact Sample Form.
The preview form cannot be submitted for consideration.
Only the online form will be accepted for consideration.
Please ensure that your form is complete before making the final submission.
You will not be able to make any changes to your form once submitted.

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Submission of this form denotes consent from the nominee for Rotary to hold
their contact information and use their likeness in promotional materials.
Upload a copy of your project representative's resume and a photograph with a
clear head shot.
Send any supplemental materials via email to PeopleofAction@rotary.org
Please do not send any materials via post.
All nominations must be submitted to Rotary no later than Friday, 17 November.

By submitting this nomination form, it is understood that candidates for consideration

have been notified and, if selected, will be contacted by Rotary International to authorize
the use of their photo, video and voice recording.

Click the forward arrows "->" below to begin your nomination form

Default Question Block

Nominator Information

Which best describes you?

I am currently a:

2023-24 District Governor

Member of Cadre of Technical Advisors
Rotarian
Rotaractor

Peace Fellow Alumnus or Global Grant Scholar

Please fill in your information

First name
Last name

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Email address
Telephone number (please include country
code)
City/town
Country
Rotary club
Cadre for Which Area of Focus?

Please fill in your information

First name
Last name
Email address
Telephone number (please include country
code)
City/town
Country
Year and location of fellowship
Year of scholarship

Please fill in your information

First name
Last name
Email address
Telephone number (please include country
code)
City/town
Country
Rotary club

Please fill in your information

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First name
Last name
Email address
Telephone number (please include country
code)
City/town
Country
Rotaract club

Please enter the nominating district number (numbers only)

Please enter the name of the 2023-24 nominating district governor

First name
Last name/surname/family name
Email address
Country

Project Nominee

This section will ask for information about the Rotary project to be considered for the
Rotary People of Action: Champions of Impact.

Is this a local project or an international project

Local
International

Is this an official Rotary club/district project

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Yes
No

Project General Information

Project name
Project city
Project state/province
Project country
Project district

Please specify the project's primary Area of Focus

Basic Education and Literacy

Water, Sanitation and Hygiene
Maternal and Child Health
Disease Prevention and Treatment
Community and Economic Development

Peace and Conflict Resolution

Environment

What is Rotary's role within the project?

Does this project have any connection to the polio eradication initiative?

Yes
No

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Is this project ongoing?

Yes

No

When did the project end (mm/dd/yyy)

Project Description

What problem or issue does/did this project address?

What was the situation before the project intervention – and how were the key issues
identified?

What is/was the sustained impact the project intended to achieve?

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What tangible or immediate results came from the project such as the number of people
trained, or the number of items distributed?

What additional short-term results came from the project such as training teachers using
a new methodology or community health workers conducting visits to households?

Who ultimately benefited from the project? What was the long-term impact, or effect, on
their lives?

What kind of data or evidence can you provide to demonstrate this impact?

How were Rotary members essential to the positive change that resulted as part of this
project? What critical role did they play?

What could others who undertake similar projects learn from your experience?

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Who participated in the project (Rotary clubs/districts or partnering organizations such as

churches/houses of worships, schools, other non-governmental organizations,
local/state/national government and business)?

How much money was spent on this project?

Amount in US dollars

Did this project receive a grant from The Rotary Foundation?

Yes
No

Please provide the name and grant number if known.

Does this project have a website?

Yes
No

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Please provide a link to the website.

Has this project received any local, national or international media attention?

Yes

No

Please provide a link to the article(s).

Project Representative General Information

First name
Middle initials
Last/family name
Address
Address line 2
City
State/province
Zip/postal code
Country
Primary telephone number
Email address

The project representative is a? (select one)

Rotarian

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Rotaractor
Peace Fellow Alumnus
Global Grant Scholar or Program Alumnus

Please specify the Rotary club

Please specify the Rotaract club

Please upload a photograph with a clear head shot. (file size must be at less than 16
MB).

Note: If you are using the Firefox browser, you may not be able to upload files. Please complete the survey in Internet

Explorer or Google Chrome.

Please upload the nominee's resume/CV as a Microsoft Word document or PDF. (files
size must be less than 16MB).

Note: If you are using the Firefox browser, you may not be able to upload files. Please try completing the survey in Internet

Explorer or Google Chrome.

Please describe your project representative’s role within the project

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Why should this person represent the project as one of Rotary's People of Action?

What was this person’s role in helping to aid the project’s measurement and evaluation?

Has this nominee ever been honored/recognized for his/her volunteer work by an
organization other than Rotary?

Yes

No

Please provide specifics about those honors (name of organization, dates awarded,
reason, etc)

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Has this nominee received any media attention for his/her volunteer work inside or
outside of Rotary?

Yes

No

Please specify the name of media outlet, date of article, reason for article.

Is the nominee active on social media (Twitter, Facebook, Instagram, etc)

Yes
No

Please provide social media screen names/handles/addresses

Twitter/X
Facebook
LinkedIn
Instagram
Other

Block 1

This completes the Rotary People of Action: Champions of Inclusion nomination form.

REMINDER TO ALL NOMINATORS:

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Submission of this form denotes consent from the project representative for Rotary to hold their
contact information and use their likeness in promotional materials.

If you have any supplemental materials that you would like included with your nominations, please
email them to Rotary External Relations at PeopleofAction@rotary.org.

ONLY CLICK THE FORWARD BUTTON IF YOU ARE READY TO SUBMIT THIS NOMINATION
FOR CONSIDERATION. YOU WILL NO LONGER BE ABLE TO MAKE ADDITIONS OR
CHANGES ONCE SUBMITTED.

Thank you for your time and good luck to your nominee!

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