Citizen of the Year Nomination Form Citizen of the Year Nomination Form Directions: Only accomplishments for the past Lodge year (April 1 – March 31) are to be recognized If you have questions, please contact the State Chairman: Cheryl Collins, 360-606-7524 or cherylacollins2006@comast.net All entries must be submitted by March 15. Your Name * Your Email * Lodge Name and Number * District * North (Julie Seeder)Central (Lynne Barnes)West (Heather Beal)South (Cheri Michaelson)East (Lana Davick) Citizen Nominated * Exalted Ruler List this person's community accomplishments for the past year 25 points possible Detail this person's impact on the community 25 points possible List any community organizations, fraternal orders or service groups this person is a member of? 5 points each If you are human, leave this field blank. Submit Start Over
