Nomination Form Everyday Hero

EVERYDAY HERO AWARDS

NOMINATION FORM

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* 1. Enter nominee contact information

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Share a list of the positive actions and activities the nominee is involved in that “improve the lives of African Americans in New Mexico”

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* 3. In your opinion what are the best attributes and characteristics of the nominee that show a commitment to community and service

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* 4. Please share a story that you’ve observed or heard of an example of the nominee’s contribution to “improve the lives of African Americans in New Mexico”

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* 5. Enter nominators contact information

Name

Address

City/Town

ZIP/Postal Code

Email Address

Phone Number

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* 6. OAAA Everyday Hero Awards

For more information contact

Tammy Watson (andreat.watson@state.nm.us)
310 San Pedro NE Ste. 230
Albuquerque, NM 87108
Office: (505) 383-6222
Direct Line: (505) 383-6217
www.oaaa.nm.state.us