KPB Environmental Award Nomination Form
Your Name *
Name of the person making the nomination
Your answer
Your Cell Phone Number *
Contact number for the person making the nomination
Your answer
Your Address *
Street address for the person making the nomination
Your answer
Your City, State and Zip *
City, State, & Zip for the person making the nomination
Your answer
Name of Person or Organization being Nominated *
Your answer
Nominee Email Address *
Your answer
Nominee Phone Number *
Your answer
Nominee Street Address *
Your answer
Nominee City, State and Zip *
Your answer
Award Category *
Choose one
if you chose other for the award category what would you call this award?
Your answer
Give a brief explanation of why this person or organization should receive the award. Include statistics like number of volunteer hours, number of pounds recycled, number of trees, shrubs, flowers planted, number of bags of trash picked up, etc *
If you wish to submit a longer answer please email it to info@mykpb.org. Please email photos that document this application to info@mykpb.org.
Your answer
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