Dave Benton Crime Fighter Award Nomination Form
Date of Submission *
* NOTE - Nominations due by June 1st. *
Nominator's name *
Name of the person nominating someone
Your Address (Street Address, City, Zip Code) *
Your Phone Number *
Your Email Address *
Nominee's Name *
Name of the person you are nominating
Nominee's Address (Street Address, City, Zip Code) *
NOTE - Nominee MUST LIVE in Champaign County
Nominee's Phone Number *
Nominee's Email Address *
Please describe the long term improvement or sustainable activity the nominee implemented or was involved with which would qualify the nominee for the Dave Benton Crime Fighter of the Year Award. Please include the nominee’s level of commitment to crime fighting within Champaign County and why you think this person is deserving of this award. *
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