Garfield County Humanitarian Service Awards

Garfield County Humanitarian Service Awards 2017 NOMINATION FORM

This nomination form and letters must be submitted by Friday February 24, 2017 at 4 pm, no exceptions!

Name of nominee: ______

Organization, if any: ______Title, if any: ______

Nomination Category: ______Volunteer ______Staff (Check one or both categories.)

Approximate age of nominee ______(Nominations can be submitted for people of any age.)

Nominee’s contact information:

Address: ______

City: ______State: ______Zip: ______

Daytime phone: ______Mobile phone: ______

E-mail: ______(Please submit this address so a committee member can contact your nominee.)

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Name of person submitting nomination: ______

Organization, if any: ______Title: ______

Nominator’s contact info:

Daytime phone: ______Mobile phone: ______

E-mail: ______

How did you hear about these awards radio newspaper other (describe)______. Please attach a letter explaining why you are nominating this person. . Nominations require supporting letters from at least three other people and no more than six. All letters must accompany this form. All materials should be emailed to [email protected] by 4 p.m. Friday February 24, 2017. Questions? Call (970) 456-8059. Thanks for your nomination. We hope to see you at the Humanitarian Service Awards event on Monday, April 3, 2017, 5:30 p.m., Grand River Hospital Ballroom, Rifle CO . . . coming soon, event details!