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Public Officials of the Year Nomination Form

Nominate individuals who have had a notable positive impact on their department or agency, community or state.

Nominations for the 2010 awards are due by the end of the day on Friday, June 4.

If you have any questions about submitting a nomination, please consult our Frequently Asked Questions. Still have questions? Contact Josh Goodman at 202-862-1439 or jgoodman@governing.com.

Nominee

First Name

Last Name

Title

Department

Address

City

State

Zip

Approximate number of Years in Position

Other Government Positions Previously Held

Other Relevant Experience

Please write no more than 600 words describing the outstanding characteristics and accomplishments of the nominee.

Please be sure to emphasize what distinguishes this person's impact in government from that of his or her peers. You may include an anecdote that provides perspective on the nominee's impact, motivation, management style, or any other relevant qualities.

Additional Comments

Reference #1

Name

Phone

Reference #2

Name

Phone

Nominator

First Name

Last Name

Title

Department

Phone

Email Address

Relationship to Nominee

Please make sure to save a copy of your nomination for your records before clicking the nominate button.