CITIZEN OF THE YEAR

KALAMA AWARD NOMINATION

Name of Nominee _________________________________________________

Address ________________________________City______________ State______ Zip ___________

Occupation ______________________________________________________

ELIGIBILITY

To be eligible for this award, each nominee must be a resident of Kalama.

QUALIFICATIONS

Please provide complete and concise information regarding the following information:

A. Community Activities

a. Civic mindedness – civic leadership achievements

b. Services to the community

c. Current activities – local, state, national

B. Character

a. Sincerity, honest, integrity, etc.

b. Compassion for all persons

c. Cooperative spirit, congeniality

C. Past Service

a. Participation in programs beneficial to the general public

b. Steadiness of purpose

c. Ability to work with others in all circumstances

ALL NOMINATION FORMS MUST BE SIGNED BY THE INDIVIDUAL SUBMITTING THE NOMINATION.

_________________________________ _____________________________________

Name of person submitting nomination Signature of person submitting nomination

Address ________________________________City______________ State______ Zip ___________

Phone number (360) _____ - ___________

Please send your nomination to: Kalama Chamber of Commerce

Citizen of the Year Award

PO Box 824

Kalama, WA 98625