Please send in, via email, your nomination and include:
Date of Nomination:
Name of Person Nominated:
Category: (Please focus your selection to the most appropriate category)
□ Outstanding commitment to Principle & Service
□ Act of Courage
□ Extraordinary Display of Character
□ Unique Personal Achievement
□ Unusual Service to A Person in Need
□ Exceptional Community Service
□ Entrepreneurship
What school does the nominee attend?
School District:
Grade:
Age:
Email Address:
Mailing Address:
Telephone:
Person Nominating the Candidate:
Relationship to Candidate:
Nominator’s Email Address, Mailing Address & Telephone:
Nominators are asked to limit their nominations to two outstanding candidates.
The nominator should clearly detail the reasons for the nomination, along with the reason the
applicant fits into the selected category. The nomination forms and accompanying material/essay
will be reviewed by a jury of select members of the Chamber.
Please include all of the reasons the candidate should be honored as an outstanding Young Citizen.
Be specific and list ALL details of exceptional service and activities that support the nomination.
Please include any substantiating information, such as letters and press clippings.
