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Public Recognitions Request Application

  1. Public Recognitions Request
  2. Please reference the requirements for each award in the Public Recognition Policy here.

  3. Please select the recognition that you are requesting:*
  4. Requestor Information

    For the following recognitions, the requestor must be different from the recipient as this will be considered as a nomination: Community Leader Award of Distinction, Wall of Honor, Memorial, Monument and/or Facility Naming

  5. Nominee Information
  6. Impact Statement

    Please see the Public Recognition Policy here for additional details. 

    For the following awards listed below, please complete the Impact Statement in its entirety:

    Community Leader Award of Distinction

    Wall of Honor

    Memorial, Monument and/or Facility Naming 


    IMPACT STATEMENT

    • Resume - Please demonstrate proof of impact of the nominee to the community with dates of service included in the resume. 
    • Letter(s) of Recommendation
    • Additional Documentation - Opportunity to further support the nominee's impact on the community

    Period of time as well as contributions recognized by a significant segment of the community and their respective industry (education, nonprofit, business) will be considered upon review of request.  

  7. Electronic Signature Agreement*
  8. After submitting this form, you will be contacted shortly regarding the status for your request.

    Thank you!

  9. Leave This Blank:

  10. This field is not part of the form submission.