Nominator Name:
Nominator Phone Number:
Nominator Address:
Nominator Email:
Relationship to Nominee:

Nominee:
Category:—Please choose an option—Youth Volunteer of the YearCitizen of the Year
Nominee Address:
Nominee Home Phone Number:
Nominee Alternate Phone Number:
Nominee Email:
Date of Birth:

Please explain, in 1,500 words or less, why you feel this individual is deserving of this award. Please use the award guidelines to help develop your application. Point form answer is acceptable.