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Person of the Year 2019 Nomination Form
This is the online nomination form for the Middle Smithfield Township 2019 Person of the Year Award. To ensure that your application is valid, please answer all questions. Incomplete applications will not be accepted. Upon submission of your nomination form, you will be brought to a confirmation page. If you do not see a confirmation page after submitting your form, please try again. If you prefer to download and mail a form, please contact Holly Freese at 570-223-8920 x132 or hfreese@mstownship.com. Nomination forms may also be picked up at the Middle Smithfield Township building.
Nominator Information
(Your Information). Please provide your personal contact information so that judges may contact you regarding your nomination.
Your First Name *
Your answer
Your Last Name *
Your answer
Please enter the best phone number to reach you at *
Your answer
Please enter your personal email address. *
Your answer
Personal Mailing Address *
Your answer
Please Briefly Describe Your Relation to the Nominee *
Your answer
Nominee Information
Please provide the information for your nomination for Person of the Year.
First Name *
Your answer
Last Name *
Your answer
Phone number (to contact if selected as a finalist) *
Your answer
Name of the organization/event that they represent? *
Your answer
What was/is the nominee's role within their organization or event? *
Your answer
What three words would best describe the person you are nominating? *
Your answer
Nominees must receive NO financial compensation for their contributions. Do you verify that this nominee is an unpaid volunteer? *
Please describe how this person went above and beyond your expectations for his or her organization or event. Please include a story that describes this extraordinary contribution in detail, and tell us why you think this person is the best candidate to receive the Person of the Year Award. *
Please note: you can resize the box below by clicking and dragging the arrow in the lower right hand corner.
Your answer
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