Nominator Name*

Organization (if applicable)*   

Address 1*    Address 2   

City*    State*   

Email*    Phone*   

Information for Consideration
Identify as many organizations that are involved in this initiative

Name of the Initiative/Partnership*   

Organization 1    Organization 2   

Please indicate other organizations   

Name and contact information for person for this initiative

Name*

Address 1*    Address 2   

City*    State*   

Email    Phone*   

If a partnership, name the contact for the other organization in the partnership

Name*

Address 1*    Address 2   

City*    State*   

Email    Phone*   

Describe the initiative/effort being nominated.  How has this benefited the Eagan community?

How many people have been involved and in what way(s)?

How has this initiative been exemplary?

Select one category that best reflects the candidate’s excellence.  (The selection committee reserves the right to reassign nominees to an award category other than those indicated below.)

 Aging in Place Initiative
 Volunteer Initiative
 Hungry Neighbors Initiative
 Wellness Initiative
 Youth initiatives with education and business connections
 Partnership with early childhood readiness initiatives or other educational efforts

Briefly explain why you are choosing this category for this nominee.

Any additional information about this nomination.

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