2011 Cook County Community Changer Award Nomination Form


In recognition of Black History Month, President Preckwinkle will be sponsoring the Community Changers Award to recognize outstanding individuals who have contributed to a positive change in their community with a positive attitude and a willingness to help in whatever capacity necessary to accomplish a task or goal.

President Preckwinkle is seeking community input for the identification of nominees for this award. A selection committee of community leaders will be charged with selecting the awardees.

Nominees must be a resident of Cook County. They should be individuals who, either in a professional or volunteer capacity have made significant contributions to the well-being of their community for which they have not received widespread recognition. There will be six categories that individuals can be nominated for: Business/Entrepreneur; Community Service; Education; Outstanding Achievement Award; Rising Star; and Youth. Elected officials are not eligible for consideration.

* 1. Who are you nominating to be a 2011 Community Changer?

* 2. Nominee Information

* 3. What Community Changer category are you nominating them for?

* 4. Please describe, in 200 words or less, why the person should be honored as a "Community Changer." Be as specific as you can.

* 5. Please list the nominee's civic activities, memberships in community groups, etc.

* 6. Please list any honors and/or awards that the person has received, that you know of.

* 7. Please provide your contact information.

* 8. What is the nature of your relationship with the nominee? Select all that apply.