Essential Worker Nomination Form
Your Name:
*
Your Email:
*
Name of Essential Worker being nominated:
*
Essential Worker's Email:
*will only be notified if selected
Essential Worker's Phone Number:
*will only be notified if selected
What essential job has this person performed during the closure of non-essential businesses?
*
Example: (Store Clerk, Mailman, Custodian, Delivery Driver, etc.)
Where does the person being nominated work?
Name and/or Location if available
Does the essential worker being nominated live and work in Nevada?
*
Yes
No
OPTIONAL: Why does this essential worker deserve recognition during this time?
SUBMIT
Should be Empty: