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Lakeland Foundation

Read Nomination Letter & Instructions

“Our heroes are those..who..act above and beyond the call of duty and in so doing give definition to patriotism and elevate all of us. America is the land of the free because we are the home of the brave.” -- David Mahoney
In the space provided in the form below, please tell us why the person you have nominated is a hero. Be sure to mention any news clips, police reports or names of witnesses who can be called to verify the heroic act. Award decisions will be based largely upon the information you provide, so please be as detailed as possible. The deadline date for submission is February 27, 2009.
If you would rather print and mail your nomination form, you may download the PDF version.

You should type your 250 word (or less) nomination essay in a word processing program such as Microsoft Word and copy-paste it into the “Why are you nominating this hero” field below. You may also email your essay to lccfoundation@lakelandcc.edu.

Nominating Organization: (if applicable)
 Nominator's Name:
Mailing Address: (Number & Street)
 City, State, Zip:
Phone Number: (XXX-XXX-XXXX)
 E-mail address:
Relationship to Nominee:
  
Nominee's Name:
 Mailing Address: (Number & Street)
City, State, Zip:
 Phone Number: (XXX-XXX-XXXX)
Hero Category:
Community Impact
Community Safety (Police/Fire/Paramedic)
Medical
Military		 Why are you nominating this hero?
You should type your 250 word (or less) nomination essay in a word processing program such as Microsoft Word and copy-paste it into the “Why are you nominating this hero” field below.

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