Citizen of the Year Nomination Form

2. City of Overland Citizen of the Year Nomination Form
4. Nominations accepted for Overland Residents and Businesses who make a positive impact on our City.
   Please complete the below form, or you may download and complete the form found at https://www.overlandmo.org/DocumentCenter/View/6825/Citizen-of-the-Year-Nomination-Form.
6. Nominee Name*
   For business nominee, enter both business name and owner/manager who has had a positive impact.
8. Nominee Address*
10. Nominee Phone*
11. Nominee Email
13. Category*
    -- Select One --CitizenBusiness Citizen
15. What organizations, committees, or clubs does the nominee belong to?*
17. Describe how the nominee is actively committed to making contributions to the committee.*
19. Describe how the nominee helps others before him/her self.*
21. Describe accomplishments or actions benefitting the community.*
23. Why do you believe this award is merited by this individual or business?*
25. Are the accomplishments or actions work-related, volunteerism, or for-profit?*
27. Do you wish your nomination to remain anonymous?*

    1. Yes
    2. No
31. Please complete the following information so we can contact you if we require additional information.
33. Your First Name
34. Your Last Name
36. Address1
37. Address2
39. City
40. State
41. Zip
43. Your Email Address:
Leave This Blank:


45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit Submit and Print

* indicates a required field