Hometown Hero Award - Nomination
The Hometown Hero Award recognizes an individual who has demonstrated exceptional courage, leadership, service, or dedication to the safety and wellbeing of our county.This award honors those who go above and beyond to protect, serve, and strengthen our community.Nominations are open to the public. All nominees will be recognized at Public Safety Day, and one recipient will be selected as this year’s Hometown Hero.
Nominee Information
Provide contact information for the individual you are nominating.
Nominee Full Name
*
First Name
Last Name
Nominee Job Title/Role (if applicable)
Department/Organization (if applicable)
Email (if known)
example@example.com
Phone Number (if known)
Please enter a valid phone number.
Format: (000) 000-0000.
If this nominee:
EMS
Fire Department
Law Enforcement/Police/Dispatch
Civilian/Good Samaritan
Description of Nomination
Describe why you are nominating this individual. Provide as many details as possible. Specific examples are encouraged.
*
Does this nomination involve a specific incident?
Yes
No, this is for ongoing service and dedication
If yes, provide date and location of incident.
What impact did this individual's actions have on you or others in the community?
What qualities did this nominee demonstrate? Check all that apply.
Courage
Leadership
Compassion
Professionalism
Integrity
Quick thinking
Dedication to service
Teamwork
Other
If other, list:
Nominator Information
Your Name:
First Name
Last Name
Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Email:
example@example.com
Relationship to Nominee:
Supervisor
Coworker
Community member
Family member
Media & Recognition Permission
All nominees will be publicly recognized at Public Safety Day and may be featured in event materials, social media, or other marketing materials. By checking below, you are acknowledging you understand and agree that this nomination may be used for public recognition purposes.
*
I understand and agree.
Submit
Should be Empty: