Shortly before his death, eminent American sculptor Paul Manship produced the design for the 2 ¾-inch diameter 14-caret gold medal presented to every recipient. Sculpted on the front in bas-relief is the Great Seal of North Carolina with the words "State of North Carolina Award" around the border. On the reverse are two scrolls, the first located in the center of the medal, inscribed with the name of the recipient and the date of the award and surrounded by a wreath. The second scroll is on the lower margin below the wreath and inscribed with the field for which the recipient is recognized. Encircling the central scroll and wreath along the outer margin is the motto Humber penned for this medal: "Achievement Is Man's Mark of Greatness."
The North Carolina Department of Cultural Resources, through a five-member North Carolina Awards Commission appointed by the governor, administers the North Carolina Awards. The commission works through committees of knowledgeable persons in the four fields from which nominees are considered. Anyone can submit nominations to the Awards Commission for consideration. By the early 2000s more than 200 individuals had received the award, including Hiram Houston Merritt (science, 1967), Samuel J. Ervin (public service, 1973), Andy Griffith (fine arts, 1984), Maya Angelou (literature, 1987), David Brinkley (public service, 1988), John Hope Franklin (literature, 1993), and LeRoy T. Walker (public service, 2004).