JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Representative Tsernoglou Non-Profit Service Organization Submission
Representative Penelope Tsernoglou wishes to acknowledge the dedication that non-profit service organizations bring to the community. Please submit the organization you believe has done exceptional work and deserves recognition!
**Non-profit service organization
must
reside within the 75th District in order to be nominated.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Non-Profit Service Organization name
*
Your answer
Organization Address
*
Your answer
Reason for being nominated?
*Please explain why you believe this organization should be nominated for their amazing work.
Your answer
Relationship with the organization
Your answer
Name of nominator and contact information.
*Please put N/A if you wish to remain anonymous
Your answer
Additional Information
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report