Nomination Form

League of Women Voters of Appleton and Post-Crescent Media

2014 Making Democracy Work

Nomination Form

The Making Democracy Work Award celebrates community leaders; individuals who have envisioned a way to improve the Fox Cities community and have mobilized others to work with them to affect change that has benefited the broader community.

This form may be completed by the nominee or by another nominator.

Nomination Form
Name of Nominee:
Address of Nominee:
Phone of Nominee:
Email of Nominee:
Name of Nominator:
Address of Nominator:
Phone of Nominator:
Email of Nominator:
What is your relationship to the nominee?
The Making Democracy Work celebrates community members who have envisioned a way to improve the Fox Cities community and have mobilized others to work with them to effect change that benefits the broader community
Please address the following questions:
1. Please explain how the individual you are nominating exemplifies leadership as described in the above paragraph, and why the nominee should be considered for the Making Democracy Work Award.
2. Please describe how this individual has impacted the Fox Cities community and mobilized others in this effort, Provide specific example of how the community has benefited from the nominee's communiity work.

Verification
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Please complete online nomination by April 17, 2014