2022 Civility Award Nomination Form

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2022 Civility Award Nomination Form

NOMINATOR INFORMATION

* Indicates required field

Your Name (the person completing this application): *

Your contact information – email and preferred phone number: *

NOMINEE INFORMATION

Nominee Name (the name of the person(s) or group you are nominating and who, if selected, will receive the award): *

Reason for your Nomination (100 words or less): *

When did the nominee’s actions occur? *

Nominee’s contact information

Phone: *

Email: *

Website: *

Additional Comments? *

Please indicate which category of recognition you feel is appropriate for your nominee: *

CIVILITY YOUTH AWARD: Recognizes young people, age 8-17 SENIOR CIVILITY AWARD: Recognizes individuals age 63 years and older CIVILITY NEIGHBOR AWARD: Recognizes neighbors or homeowner associations CIVILITY AT WORK AWARD: Recognizes employers and workplaces COMMUNITY CIVILITY AWARD: Recognizes community-based, faith-based, or non-government organizations CIVILITY BUSINESS AWARD: Recognizes for-profit business and employers PUBLIC SERVANT CIVILITY AWARD: Recognizes notable employees of public organizations or agencies ELECTED CIVILITY AWARD: Recognizes those who hold elected office LEADERSHIP CIVILITY AWARD: Recognizes notable leaders in our region CIVILITY COOPERATIVE AWARD: Recognizes where two or more individuals or organizations modeled collaboration and civility CIVILITY INFLUENCER OF THE YEAR: Recognizes social media influencers who modeled civility

* - Required

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