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  twright@ymcafoothills.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.

NOMINEE:  ___________________________________________________________ 
                                                  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.