Community Champion Nomination

Community Champion

This award recognizes a young professional who has made significant contributions to their local community through volunteer work, advocacy, or community-building efforts, demonstrating a strong commitment to social responsibility.

Nominee Name(Required)

First Last

Nominee Phone

Nominee Email(Required)

Nominee Date of Birth

Nominee Ethnicity(Required)

Native American

Asian

African American or Black

Hispanic and Latino American

Pacific Islander

Other

Enter Nominee Ethnicity

Nominee Current Organization(Required)

Nominee County/City of Organization(Required)

Organization President/Chair

How has the nominee positively impacted the community? Please provide specific examples.(Required)

In what ways has the nominee demonstrated leadership in the community? Describe how the nominee has shown leadership, either formally or informally.(Required)

How has the nominee's work inspired or mobilized others?(Required)

What long term benefits has the community gained from the nominee's efforts? Explain the lasting impact of the nominee's work on the community.(Required)

Is there anything else you would like to add about the nominee that supports their case for being a Community Champion?(Required)

Name

This field is for validation purposes and should be left unchanged.

Community Champion Nomination

Community Champion

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