2023 Citizen of the Year Award Nomination Form

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The Citizen of the Year Award is given to recognize a Henry County citizen who, through their personal involvement, leadership abilities, and selfless giving of their time and talent has positively affected Henry County and the lives of its citizens during 2023. The Citizen of the Year Award honors those who's contributions to Henry County have been both a recent effort resulting in a substantial benefit to the county, and a steady, reliable long-term history of service to the county. Nominee must be a resident of Henry County, Indiana.

The Citizen of the Year will be announced at the March 20, 2024 Chamber Awards Gala. The final three from each award and their nominators should plan to attend the event. The final three will be notified no later than March 5, 2024.

Nominations may be submitted by online form, or a printed form may be obtained from the Chamber office by calling 765-529-5210. If additional space is needed print form and attach additional page/s. Mail nomination to: New Castle Henry County Chamber of Commerce, 100 S. Main Ste. 108, New Castle, IN 47362.

Nominations print or online must be received by the Chamber office by 4pm on February 23, 2024.

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Nominee's Full Name *

Nominee's Full Street Address *

Nominee's Phone Number *

Nominee's Email

Nominee's Employer

Provide an overview of the nominee's recent contributions to the welfare and betterment of the community. (500 characters) *

Explain how the nominee's recent contributions have an impact on Henry County. (500 characters) *

Identify the nominee's recent participation in community activities and civic enterprises. (500 characters) *

Please identify any extraordinary acts of kindness or heroism within our community performed by the nominee. (500 characters)

Additional Comments

Nominators Full Name

Nominator Mailing Address

Nominator Phone

Nominator Email

Relationship to Nominee (ie: family, co-worker, etc.)

If your nominee is selected as one of the final three we would like to invite you to the gala for which we will need your consent to contact you via your email address. There are also occasions where a nominee would like to know who nominated them, in which case we will reach out to you via email for your consent to pass on your details. *

I consent to be contacted by email.

I consent to be contacted by telephone.

I wish to remain anonymous.

I do not wish to be contacted.

必填

The Chamber does not sell or distribute personal information.

Yes, I would like to receive the bi-monthly Chamber e-blast newsletter. The newsletter contains local event and business as well as Chamber information. (If you select yes be certain you have included your email address in the nomination form)

Yes

Today's Date *

YYYY

Thank you for submitting a nomination!

Please call the Chamber at 765-529-5210 if you have any questions.

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