PLEASE READ BEFORE YOU BEGIN:

2. VOLUNTEER RECOGNITION AWARD NOMINATION FORM

   Individual and Organization Nominees should have actively volunteered over the past year and meet the following criteria: 

   ❖ Positively influenced the City of La Habra. 

   ❖ Contributed unique, innovative or creative perspectives to a City program. 

   ❖ Shown dedication by length of involvement, number of volunteer hours, or by a strong concentration of service. 

   ❖ Exceeded volunteer program requirements. 

   ❖ Demonstrated leadership ability. 

4. The award categories are: Please select a category.
   -- Select One --COMMUNITY IMPACT AWARD – Positively impacted the CommunityPOINT OF LIGHT AWARD – Created change in the Community and inspired others to make volunteerism a part of their lifestyleNEIGHBORHOOD LEADERSHIP AWARD – Recognized a need for improvement and took a proactive role in addressing the Community.
6. Name of Nominated Individual/Organization:
8. Address1
10. City
11. State
12. Zip
14. How long has this Individual/Organization been involved in a Volunteer Program?
16. How has this Individual/Organization contributed to your program or in the community?
18. In what way is this Individual’s/Organization’s involvement in the community unique, innovative or creative?
20. What characteristics and/or teaching methods make this Individual/Organization a successful volunteer?
22. Briefly describe the impact this Individual/Organization has had on the programs or services offered in the community:
24. Additional Comments:
26. Nominated by:
28. Name of Organization:
30. Email:
31. Contact Number:
33. Nominations are due by 5 p.m. on Friday, April 10th .
    
    

    Drop Off: La Habra Community Center, 101 W. La Habra Blvd. 

    
    

    For more information, please call 562-38-4200 or

    Email: mmontoya@lahabraca.gov

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