Christine Milosich Public Safety Service to Youth Award

Nomination Form

Presented by the Town of Tonawanda Youth Board

1. This Award is presented to an individual 21 years or over, in the field of public safety (eg. police, fire, paramedics, crossing guards, security guard, dispatchers, liaisons, etc.).
2. He/She must have had some impact on the youth of the Village of Kenmore or the Town of Tonawanda.
3. He/She must have given over and above what is required through their normal job or volunteer duties.
4. The recipient must reside or work in the Town of Tonawanda/Village of Kenmore.

Past Recipients:
2021 Christine Milosich

2022 Jesse Haug

2023 William Harbin

(Current Youth Board Members are not eligible for this award)

Question Title

* 1. Name of Nominee

Question Title

* 2. Nominee's Contact Information

Company *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Phone Number *

Question Title

* 3. Nominated By

Question Title

* 4. Your Contact Information

Company

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Phone Number *

Question Title

* 5. Please explain the nominee's employment and involvement with youth

Question Title

* 6. # of youth the individual works with

Question Title

* 7. How long has the nominee been working with youth

Question Title

* 8. Please explain in your own words why you feel this individual should be chosen as the Christine Milosich Public Safety Service to Youth Award recipient.