Mayor Lyle Anderson Gold Leaf Award for Volunteer Service Youth Nomination Form

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PURPOSE OF AWARD: The purpose of the Mayor Lyle Anderson Gold Leaf Award for Volunteer Service is
to honor outstanding citizens who are making valuable contributions to the community
through volunteer service in a wide variety of categories, such as health, recreation,
arts, environment, education, public safety, civic service or other human services.

QUALIFICATIONS FOR AWARD: The volunteer must be a resident of Lebanon,
or the volunteer service must be performed in Lebanon. The volunteer must be less than 18 years of age when service was performed. The volunteer activity can be in a structured setting or on an informal basis. For more information, email dgean@lebanonmo.org or call 417.991.2310. Nominations must be submitted by 5 p.m. April 7.

Email *

Nominee's Name - First and last *

Nominee Street Address

Nominee City *

Nominee State

Nominee Zip

Nominee Phone Number

Nominee email address *

Detailed description of Volunteer Activity *

Was the volunteer activity performed in Lebanon? Where?

Your Name - First and Last *

Relation to the Nominee *

Your phone Number *

Your email address *

Submit

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