Nomination Form

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Sharon St. Hilaire Community Service Award

Nomination Form

Nominator Information:

Name______________________________________________________________

Address____________________________________________________________

Contact information___________________________________________________

Relationship to nominee________________________________________________

Nominee:
Name_______________________________________________________________

Address_____________________________________________________________

Seekonk affiliations & organizations:

 

Professional background & personal, family, or other information:

 

 

Please explain why this person is being nominated:

 

 

Deadline for submissions is May 15, 2013. This form should be mailed to: Peter Fuller, Seekonk Library 410 Newman Avenue Seekonk, MA 02771. This form can also be e-mailed to: library@seekonkpl.org

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