Please complete this form for each business category on behalf of a deserving organization in Lake County Florida for the 2023 Community Service Awards banquet.

Review the list of the previous award winners as recipients can only win one time in each category.




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* 1. Under what category does the nominated organization qualify?

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* 2. Please provide the following information about the organization.

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* 3. Other awards or recognition received by nominee related to the qualifying category.

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* 4. Club, Organization, & Positions related to the qualifying category.

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* 5. To complete the application, attach a supported file providing the reasons for nomination to help differently the nominee and highlight their achievements.  (No more than 500 words)

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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* 6. Please provide your contact information below.

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