Bloomington HRC - Adult MLK Award Nomination Form

Nomination for the
2025 Bloomington Human Relations Commissions
Adult MLK Award

The Bloomington Human Relations Commission has established this award to recognize the achievements of individuals who have made outstanding contributions to human relations in the City of Bloomington.

Nomination Criteria - Who is Eligible

1. The nominee must be a resident of Bloomington
2. Self-nominations will not be accepted
3. Bloomington Human Relations Commission staff, family members and past winners are not eligble

Selection Criteria

A demonstrated commitment to improving cooperation and fostering mutual respect among people
of different racial, ethnic, religious and other backgrounds.

Nomination Process

Complete the nomination form. Nominations will be judged solely on the responses to questions on the nomination form; no supporting materials will be accepted.

Commissioners will review the nominations and determine the award winner.

Questions? Contact: Nikita Richards (309) 434-2309

NOTE: Once you create an account you will be able to start a nomination and come back later to complete.

Save & Return

Save your progress and complete this form later. (optional)

Nominator Information

Nominator - First Name *

Nominator - Last Name *

Address 1 *

Address 2

City *

State *

Zip Code *

Phone *

email address

Is the nominee aware that you are nominating them for this award? *

Yes

Nominee Information

Nominee - First Name *

Nominee - Last Name *

Address 1 *

Address 2

City *

State *

Zip Code *

Phone *

Email Address

What school does the student attend? *

What grade is the student in?

Nomination Questions

1. Please explain the degree to which the nominee’s services/ actions have made a lasting or meaningful contribution or impact on their community. *

2. What has been the length and degree of the nominee’s service? *

3. How has the nominee influenced others to emulate or aspire to community service? *

4. How has the community or an organization recognized the actions of the nominee or the service they perform as valuable to the community? *

Confirmation of accuracy

I agree that the information provided on this nomination form is true and accurate. I also agree that if any information provided is not true the nomination will be void. *

Yes