LA CAÑADAN OF THE YEAR CANDIDATE SUBMITTAL FORM
Must be received no later than Friday, March 3, 2017
Please submit to: Kiwanis Club of La Cañada - La Cañadan of the Year
c/o Tyler S. Wright
1930 Foothill Boulevard
La Cañada Flintridge, CA 91011
or email firstname.lastname@example.org
CRITERIA FOR SELECTION: Candidates will be selected on:
- Their current and long-term broad-based involvement in volunteer community service;
- Their demonstrated leadership qualities that show initiative; and
- Their active roles in bringing positive recognition to the community of La Cañada Flintridge.
Individual or Couple (please circle)
Nominee's Address: _________________________________________________________
Nominee's Phone: ___________________________ Email: ________________________
Please check those characteristics which apply to your nominee.
- The nominee(s) volunteers their time in community services for the youth/schools
- The nominee(s) volunteers their time in a church/house of worship
- The nominee(s) volunteers their time in other community services
- The nominee(s) volunteers their time in service clubs
- The nominee(s) volunteers their time in civic activities
- The nominee(s) demonstrates leadership
- The nominee(s) gives positive recognition to the City of La Cañada Flintridge
NOTE: Please attach a written description expanding on the nominee's volunteer history.
Your Name: ______________________________________________________________
Your Address: ______________________________________________________________
Your Email Address: _________________________________________________________
Signature of nominator: ______________________________________________________
After receiving your nomination, a member of the Kiwanis Club may contact you to obtain additional details regarding your nominee.