Clintonville Heroes Award Nomination Form

The Clintonville Area Foundation is accepting nominations until July 31, 2017, for its annual Community Heroes Award.

This award was established in 2011 by Clintonville native Dan Olk to recognize and celebrate outstanding volunteer service that greatly enhances Clintonville area communities. The award, which comes with $2,000 for the winner to donate to local charities, is supported through the Clintonville Area Foundation. It will be presented during the Foundation’s 2017 annual fund-raiser, A Night in Tuscany, on Sept. 23, 2017, at Marion Body Works.

Nominees must meet the following criteria:

Exemplify the spirit of community service.
Make an outstanding contribution to the community through volunteer service.
Demonstrate exceptional commitment, service, creativity, cooperation, or leadership.
Serve as a role model for others in their community.
Inspire others to engage in volunteer service.
Receive no financial compensation for their volunteer activities.
Perform the majority of his/her volunteer work in the greater Clintonville area, defined as the Clintonville Public School District. He/she need not reside in the area.

Complete this online form and click “submit” to nominate a hero.

Clintonville Area Foundation Community Hero Award

Nominee's name: *

Address: *

City: *

State: *

ZIP: *

Email *

Phone *

How has the nominee demonstrated exceptional service, creativity or leadership through his or her volunteer work? Has the nominee inspired other community members to contribute? *

Why do you believe the nominee is deserving of this award? For example, describe the significance of the nominee's service to the greater Clintonville area (Clintonville Public School District) and the benefits gained by its residents. *

List any organization in the greater Clintonville area for which the nominee has volunteered. For each organization, state the duration and type of service. *

Nominator's name: *

Home phone: *

Daytime phone: *

Email: *

Address *

Address

City

State/Province

Zip/Postal

Date *

Office Phone

920.830.1290

Address

4455 W. Lawrence St
Appleton, WI 54914
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Office Hours

8:00am - 11:30am
and noon - 4:00pm
Monday-Friday

Confirmed in compliance with national standards for U.S. community foundations.