2019 Nomination Form

AWARD NOMINATION CATEGORY: (Select one)

Philanthropist of the YearVolunteer of the YearOutstanding Youth in PhilanthropyOutstanding Corporation or Foundation

NOMINEE INFORMATION: (Name as it should appear on all printed materials and award)

All fields are required.

Name

Group/Org. Contact:

Address:

City, State, Zip:

Telephone:

Email

NOMINATOR INFORMATION:

All fields are required.

Nominated By:

Organization:

Address:

City, State, Zip:

Telephone:

Email

SUPPORTING MATERIALS: ( .doc .docx or .pdf )

Your Letter of Support: (Required)

Additional Organizations Letters of Support: (Optional)