The Perry Rotary Club will honor an outstanding civil servant for the 2017 year. Individuals who work or volunteer in the following areas are eligible for this award: Law Enforcement, Emergency Services, Fire Department, Health Care, Human Services/Other.


Selection Process: All eligible nominees for this award will be considered by Perry Rotary Club’s Selection Committee. The committee will make the final decision and will notify the winner of the award. The winner will also be notified of the date, time, and location of the award presentation.


Nominations: To nominate an individual, simply complete this forum and drop it off or mail it to the circulation desk at the Perry Public Library, 1101 Willis Avenue. Nominations will be accepted until 4 p.m., Nov. 30.


**Sample of the questions asked in the forum. Physical forms are available at the Perry Public Library and the McCreary Center.


NOMINATION FOR AWARD:


AREA OF SERVICE:


NOMINEE’S ADDRESS:


NOMINEE’S PHONE NUMBER:


REASON YOU BELIEVE THIS PERSON DESERVES THE AWARD:


NOMINATED BY:


*PHONE NUMBER [In case we need to contact you with a question]: