Submission Form for 2023
There are 3 sections to the Submission Form:
1. A Nominee Section - Where you will tell us about who you are nominating.
2. A Contribution Section - Where you will describe the impact the Nominee is having in the community. PLEASE NOTE: You can develop the narrative and ‘paste’ it into this section or key it directly into the Submission Form.
3. A Nominator Section - Where you will tell us about yourself.

This information will not be used by anyone except the Rotary Club of Evansville.
NOTE: You  will need to complete and submit this form in one session.
Nominee Information
First Name *
Last Name *
Age *
Location? *
Nominee's Personal Phone Number *
Nominee's Personal Email Address *
Nominee's Job Title *
Nominee's Company *
Nominee's Work Phone *
Nominee's Work Email *
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