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2. YOUR Name*
3. YOUR City*
5. YOUR Phone Number*
6. YOUR Email Address*
8. 

10. A selection committee of five individuals will be appointed by the Mayor. The committee will use the following rubric to evaluate nominees:

    1. Safe & Welcoming: Community Service and Volunteering
       1. Excellent: Sustained, significant, selfless service impacting many
       2. Good: Regular, meaningful volunteering, sense of responsibility
       3. Fair: Participates in occasional community events

     

    2. Prepared & Resilient: Leadership and Initiative
       1. Excellent: Developed or led major community projects
       2. Good: Takes initiative in groups, dedicated to a cause
       3. Fair: Supports leaders, shows potential for leadership

     

    3. Dynamic & Flourishing: Positive Character and Values
       1. Excellent: Role model demonstrating excellence and integrity
       2. Good: Consistently shows good character and dedication
       3. Fair: Generally reliable, professional, and respectful

     

    4. Excellent & Connected: Community Impact and Engagement
       1. Excellent: Dedicated to long-lasting positive change
       2. Good: Actively involved in community issues
       3. Fair: Attends community meetings, supports local events
12. NOMINEE Name*
13. NOMINEE City*
15. NOMINEE Phone Number
16. NOMINEE Email Address
18. Narrative*
20. Upload a photo of your nominee*
22. Optional additional photo
23. Optional additional photo
25. Optional video of your nominee
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

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