Golden Lightkeeper Awards Nomination Form

Contact Information for Nominator

First Name

Last Name

Email Address

Phone

Street Address

City

State

Zip Code

Nomination Details

Award Category

Youth Individual

Youth Group

Adult Individual

Adult Group

Education

Group Name

First Name

Last Name

Email Address

Phone Number

Gender

Male

Female

Age

What organizations has the nominee volunteered with?

How many years has the nominee volunteered within the community?

On average how many hours per week does the nominee volunteer?

What is an example of the nominee showcasing an outstanding commitment to volunteerism?

What are the special skills and qualities the nominee displays?

What impact does the nominee have on crucial needs within the community?

Upload picture of individual or group actively volunteering

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