2019 Janet Clemmons Community Service Award Nominations - Online Form
Supports to Encourage Low-income Families (SELF) was founded in 1995 by the late
Janet Clemmons. As a Butler County Commissioner, she understood the challenges
faced by disadvantaged families and those who serve them. Mrs. Clemmons' vision was
for Butler County to have its own community action agency that would help low-income families find a path to self-sufficiency through education and employment.

SELF proudly carries on Mrs. Clemmons’ legacy everyday with the help of many
volunteers, supporters and community partners.

SELF presents the Janet Clemmons Community Service Award annually to an individual
who, primarily through volunteer efforts, has provided significant support and service
to the low-income people of Butler County.

The Janet Clemmons Community Service Award for 2019 will be presented at SELF’s annual awards dinner on April 26, 2019. All nominees will be honored for their service to the community.

NOMINATIONS ARE DUE BY FEBRUARY 15, 2019 AT 5:00 P.M.

To nominate a special community member, fill out the form below as well as a Letter of Nomination.

Please fill out the following about the person you are nominating:
Nominee's Name: *
Address: *
Phone: *
Email: *
Organization: *
Title: *
Please fill out the following about yourself:
Your Name: *
Address: *
Phone: *
Email: *
Organization:
Title:
Letter of Nomination:
Please upload a letter of nomination (Word Document or PDF file, no longer than 3 pages) which addresses the following topics: List any and all committees, organizations or boards the nominee is actively supporting and how they are supporting them. Highlight how the nominee goes above and beyond in helping low-income individuals and families in Butler County. Provide any personal information that supports your nomination. *
Required
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