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Community Health Service Award Nomination Form

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Each year the Board of Health accepts nominations for a Community Health Service award to be given out at their Annual Awards Luncheon. The Community Health Service award is given to an individual or organization that has demonstrated exemplary community service and volunteerism on health related projects.

Nominations can include a short story (1 or 2 paragraphs) with highlights, accomplishments and examples of why the individual, organization or business is deserving of the award. Nominations should be approximately one typed page and are due by Tuesday, March 16, 2010. Send nominations to: Steve Beal, Assistant Health Director, Lincoln-Lancaster County Health Department, 3140 'N' Street, Lincoln, Nebraska 68510 or email us.

You can also fill out and submit the on-line nomination form. The form must be submitted by March 16, 2010.

On-line Award Nomination Form


Nominee Information

Nominee Name
Mailing Address
City
Zip Code
Phone
E-mail

Nominated By

Name
Mailing Address
City
Zip Code
Phone
E-mail

Written Narrative

Describe how the nominee's efforts and achievements fulfill the eligibility:

Narrative:

Questions?

Call 402-441-8093


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