Waterbury Acts of Kindness

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Waterbury is a community of amazing folks, and Revitalizing Waterbury wants to thank those who have gone above and beyond with Waterbury Bucks which can be used at over 50 of our local businesses! You can nominate someone who provided great service at a business, went above and beyond as a volunteer, did an otherwise thankless task, brightened your day, or did something else to help make our town a better place. Nominees can be anyone who lives, works, or positively impacts the Waterbury community. Anyone of any age is eligible to be recognized, and anyone is eligible to nominate someone.

Provide as much information as possible below and submit nominations by Sunday, November 20. During the week of Thanksgiving, everyone who is nominated will receive a thank you note from Revitalizing Waterbury along with Waterbury Bucks for their Act of Kindness.

For questions or additional information, contact Karen at karen@revitalizingwaterbury.org.

Nominee's Name *

Your Name *

Tell us why you're nominating this person. *

Please provide any info on how to contact the person. A mailing address is ideal, but email, phone, where they work, or any info that might help us to track them down is helpful! *

Please provide your email so we can get in touch if we have any questions (optional).

If selected, would you like us to let the person know that you nominated them? *

Yes, you can let them know that I nominated them.

No, I'd like to remain anonymous.

Any additional information you'd like to share?

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Revitalizing Waterbury. Report Abuse

Forms