G.C.C. "Citizen of the Year" Nomination Form

Name of Nominee_____________________  ____________________________________________

Address_________________________________________________________________________________
If you are nominating more than one person please put their names, addresses and phone numbers on the back of this form.

Telephone: Day ____-_____-______ evening-_____-_____-______ other-_____-_____-_____

Sponsor-________________________________________________________________________

(full name of nominating resident or organization)

Telephone Day ____-_____-______ evening-_____-_____-______ other-_____-_____-_____

Boards, Committee, Chairs, Projects,

______________________________________________________________________________________

______________________________________________________________________________________

Reasons for nomination:
Use the back of this form if more space is needed.