Empowerment Judging Form – JCI USA

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Empowerment Judging Form

JCI USA Empowerment Award Judging Form

Presented annually to the members who best exemplify the JCI Mission and Vision through personal and professional growth outside of their JCI experiences. The name reflects JCI's underlying "WHY" of empowerment.

Judges Name(Required)

First Last

Chapter

State(Required)

Nominee Name(Required)

Rating Scale (for all statements)

Please choose a number 1-5 for all statements. 1 = Strongly Disagree \ 5 =Strongly Agree

Section 1: Personal & Professional Growth

Rate your agreement with each statement.

The nominee has shown significant personal growth beyond their JCI involvement.(Required)

The nominee has demonstrated measurable professional growth outside of their JCI roles.(Required)

The nominee’s achievements reflect a sustained commitment to self-improvement.(Required)

Section 2: Leadership & Self-Motivation

Rate your agreement with each statement.

The nominee has demonstrated leadership that extends beyond JCI.(Required)

The nominee exhibits self-motivation, initiative, and ambition.(Required)

The nominee shows perseverance in overcoming challenges or obstacles.(Required)

Section 3: Community Impact & Participation

Rate your agreement with each statement.

The nominee has participated in activities that positively impact the broader community.(Required)

The nominee’s contributions have influenced people outside their JCI chapter or state organization.(Required)

The nominee’s impact extends beyond what is expected of an average member.(Required)

Section 4: Exemplification of Empowerment

Rate your agreement with each statement.

The nominee’s growth reflects JCI’s mission and core values.(Required)

The nominee serves as a role model who inspires others to grow personally and professionally.(Required)

The nominee’s story demonstrates empowerment in tangible ways (impact, transformation, leadership).(Required)

The submission clearly connects empowerment to leadership development.(Required)

Section 5: Overall Empowerment Impact

Rate your agreement with each statement.

Overall, the nominee exemplifies empowerment through their personal and professional growth.(Required)

The nominee’s growth reflects intentional effort rather than circumstance alone.(Required)

The nominee’s empowerment journey demonstrates meaningful transformation.(Required)

The nominee’s impact extends beyond themselves to positively influence others.(Required)

Overall Comments(Required)

Judges Attestation(Required)

I reviewed this submission in full.
I evaluated this project/program fairly and objectively.
I applied the scoring criteria consistently and without bias.

I attest that the above statements are true.