2021 POWER Lunch Nomination Form

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Each year the Wisconsin Alliance honors individuals from across the state for their contributions to the quality of life for seniors. Awardees and 1 guest are free to attend, receive a plaque, and are recognized by the Alliance and attendees.

Please complete this form and include a short statement about why the nominee should be awarded.

Nominating Individual *

First and last name

Nominating Organization Information

Nominator Phone Number *

Nominator City *

Nominator Email *

Nomination Category

Nominee *

First and last name

Nominee Union (if applicable)

Nominee Phone number *

Nominee City *

Nominee Email *

Submit a short statement about why the nominee should be awarded *

Submit

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