Outstanding Citizen Award - Nomination Form

Nominator Information

Nominator First Name: *

Nominator Last Name: *

Nominator Email Address: *

Nominator Phone Number: *

Nominee Information

Nominee First Name: *

Nominee Last Name: *

Is the nominee a Riverton resident? *

Yes

I'm not sure

Nominee Phone Number: 🛈

Nominee Email Address: 🛈

Please describe in detail why you believe the nominee is deserving of the Outstanding Citizen Award? *