Sue Panek Community Impact Award
All nominations must be submitted prior to Friday, December 3, 2021.
Your Name
*
First Name
Last Name
Your Email Address
Your Cell Phone Number
Name of Individual Nominee
First Name
Last Name
OR
Name of Group Nominee
Title(s) of Nominee(s)
*
Organization of Nominee(s)
*
Does the nominee live and/or work in Winnebago County - south of Neenah/Menasha?
*
Yes
No
Please explain why the person or group you are nominating deserves to win the Sue Panek Community Impact Award for 2022.
Letter of Support - 1 of 3
*
(PDF, DOC, DOCX, JPG or PNG)
Letter of Support - 2 of 3
*
(PDF, DOC, DOCX, JPG or PNG)
Letter of Support - 3 of 3
*
(PDF, DOC, DOCX, JPG or PNG)
Submit Nomination
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