Giraffe Sighting Report
Thank you for spotting a risk-taker for the common good, and for caring enough to complete a sighting report. If your nominee is commended as a Giraffe, you will receive copies of the announcement letter and of the commendation itself. Click on read more and print out the form—fill it in and mail to Giraffe, or scan and email to This e-mail address is being protected from spambots. You need JavaScript enabled to view it .
Nominee’s name:
Nominee’s address:
Nominee’s main phone number:
Nominee’s fax number:
Nominee’s email address:
What is the best way to contact your nominee?
1. What has the nominee done for the common good?
2. How long has the nominee been doing this?
3. What did the nominee risk as a result of his/her actions for the common good? Please provide anecdotes that will help the jury evaluate the risk—the most common reason nominations have failed in the past is that the jury hasn’t seen a risk in the information. For example, has your nominee stood up for the common good against powerful opponents, angry neighbors or coworkers? Could s/he have been fired or his/her livelihood otherwise endangered? Was there physical danger or threats? Did the nominee endanger his/her health? Did his/her actions cause a wrenching and un-welcome change of lifestyle? If the risk has been time or money, please be as specific as you can about the percentage of the nominee’s time or income that is involved.
4. If the actions for which you are nominating this person are part of his/her paid employment, please tell us how the acts go significantly beyond the job description.
5. If your nominee, in the course of serving the common good, created a new organization which now pays him/her, how many years or months did he/she need to work without a paycheck?
6. If the nominee has committed civil disobedience, what laws were broken and why?
7. If your nominee has sued or is suing a person or an institution, please give details. If the litigation involved/involves significant award (for instance for damages) please tell us how such an award was or is planned to be spent.
8. Who else knows your nominee’s story? (At least two such references are needed)
Contact information for referral person #1:
Name:
Phone:
Address:
Fax:
Email:
Mobile phone (if known):
Relationship to nominee (how do they know the nominee?):
Contact information for referral person #2:
Name:
Phone:
Address:
Fax:
Email:
Mobile phone (if known):
Relationship to nominee (how do they know the nominee?):
9. Your Name:
Phone:
Address:
Fax:
Email:
Mobile or alternate contact phone number:
Relationship to nominee (how do you know the nominee?):
10. Please provide (via email, fax or US mail) any additional information about the nominee that you feel would be helpful in supporting this nomination. Newspaper articles and websites are particularly helpful.
SUBMIT YOUR SIGHTING REPORT
Please complete this form and either mail it, attach it to an email to This e-mail address is being protected from spambots. You need JavaScript enabled to view it , or fax it to us. To fax, use this number: (360) 221-7817.
If you’re using the postal service, here’s the address:
Giraffe Heroes Project
PO Box 759
Langley WA 98260
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YOU & THE FOUNDER
From time to time, Ann Medlock, this Project's founder, does a brief but inspiring email called Heads Up. You can check out past copies here. They're so good (and so free) we bet you'll join the Heads Up circle and send them on to friends & family.
For further wit & wisdom from Ann, check out her speeches, radio commentaries and OpEds.
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