*1.Name of Nominee:(Required.)

*2.Nominee Phone Number:(Required.)

*3.Nominee Email Address:(Required.)

*4.Nonprofit organizations, civic groups and/or partners involved:(Required.)

5.Brief paragraph (3-5 sentences) as to what the recent solution or impact has been in the community as a result of their collaborative efforts to go after something bigger - and better - together!

*6.Nominator First and Last Name: (Required.)

*7.Nominator Phone Number:(Required.)

*8.Nominator Email Address:(Required.)