LifestyleLeadership Actions Facebook Tweet Email 10News Leadership Nomination Form and last updated 2021-10-14 18:46:05-04 Submission Form Nominee Full Name Organization Name City Nominee Email Nominee Phone Number Nominator City of person making nomination Phone number of person making nomination Email of person making nomination Contribution to the community People served Is nominee still involved? Volunteer or paid? How long has the program been around? Website Relationship to the nominee On-camera as part of the presentation I'm not a robot I'm not a robot Submit Copyright 2019 Scripps Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. Sign up for the Breaking News Newsletter and receive up to date information. now signed up to receive the Breaking News Newsletter. Click here to manage all Newsletters Leadership Nominate a Leader Today!