Form

City of Bloomington Commission on the Status of Black Males
Annual Recognition of
Outstanding Black Male Leaders of Tomorrow
Nomination Form

Purpose of Award

To recognize and affirm the outstanding contributions made to our community by African American youth/young men and to encourage the development of future leaders.

Criteria

Nominee must have been a Monroe County resident for at least one year.
Nominee must be either:
a) a high school aged African American male who has demonstrated outstanding leadership, scholarship, and/or has been personally involved in making tangible, visible, and meaningful contributions to the Bloomington community; or,
b) an adult African American male no older than 30 years of age who has demonstrated outstanding leadership, scholarship, and/or has been personally or professionally involved in making tangible, visible, and meaningful contributions to the Bloomington community.

The Deadline for submitting nominations is February 12, 2013.

The award will be announced and presented at the 2013 City of Bloomington Black History Month Gala on Friday, February 23, 2013 at the Hilton Garden Inn .

Past award recipients includeMatt Herndon, Cordero L. Rhyne, Alvin Henry, Gerald L. Mitchell, Eddie R. Cole, Jr., Rashawn Ray, Adrian Land, Aaron Barnes and Myles Adams.

Nominee Name*

Nominee Street Address*

City*

State*

Zip*

Nominee Phone*

- Area Code Phone Number

Nominee E-mail

City of Bloomington Commission on the Status of Black Males
Annual Recognition of
Outstanding Black Male Leaders of Tomorrow
Nomination Form

Purpose of Award

Criteria

PERSON BEING NOMINATED:

NOMINATED BY:

Nomination

City of Bloomington Commission on the Status of Black Males Annual Recognition of Outstanding Black Male Leaders of Tomorrow Nomination Form

Purpose of Award

Criteria

PERSON BEING NOMINATED:

NOMINATED BY:

Nomination

City of Bloomington Commission on the Status of Black Males
Annual Recognition of
Outstanding Black Male Leaders of Tomorrow
Nomination Form