Submit Nomination

** Nominations are closed for 2017 **

Nomination Form Guidelines 2017

Nomination Rules & Regulations

All entries must be submitted by a nonprofit 501(c)(3) community service organization.  The Man and Woman of the Year Committee reserves the right to deny any submissions not meeting the specified criteria.

Entries will be accepted by email and by U.S. Mail. Please provide the answers to these questions, along with a digital .jpg image of your nominee(s) available prior to beginning the online form.

To mail in your form, please send to: Lois Bauccio, c/o Man and Woman of the Year Committee, 24320 Main Street, Santa Clarita, CA 91321.

To email in your form, please send to: mwoy@hometownstation.com.

Forms must be completed and submitted (or postmarked) no later than Monday, January 30, 2017, at 5:00 p.m.

 

Nominating Organization Information

Contact Name

Contact E-mail

Nominating Organization

Mailing Address

Daytime Phone Number

Alternate Contact Phone Number

 

Nominee Information

Name

Contact E-mail

Mailing Address

Daytime Phone Number

Alternate Contact Phone Number

 

Nomination Form

List the nominee’s current occupation and position.

List the community organizations, years of service, and positions held by the nominee in the following format.

  • Organization:

–    Years of service:         

–     Positions held:

Describe how this individual’s volunteerism has impacted your organization and the community (150 words or less).

Describe other contributions made by your nominee that should be considered in the selection (i.e., special personal effort, in-kind, or intangible contributions, outstanding leadership. (150 words or less).

Biography and Photograph

Please provide a brief biography of your nominee.  Biographies should not exceed 500 words.  Please be concise. Please attach a high-resolution .jpg image of the nominee.