Normal Human Relations Commission Nomination Form - ADULT MLK Award

Nomination for the
2023 Normal Human Relations Commissions
Adult MLK Award

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

Nomination Criteria - Who is Eligible

1. The nominee must be a resident of Normal
2. The activity for which the individual is being nominated must be not-for-profit and not a part of thier job.
3. Self nominations will not be accepted
4. Normal 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: Tony Jones 309 242-4049

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

First Name *

Last Name *

Address 1

Address 2

City

State

Zip Code

Phone

Email Address

Comment / Misc.

Nomination Questions

1. What are your reasons for nominating this individual? *

2. How has the nominee demonstrated commitment to improving cooperation and fostering mutual respect among people of different racial, ethnic, religion and other backgrounds *

3. How has nominee’s efforts addressed discrimination, prejudice and the effects of past discrimination? *

4. What recognition has the nominee received for his/her service to others? *

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