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Mayor’s Medal of Honor Nomination Form

You are here: Home1 / City Government2 / Mayor and Council Members3 / Mayor’s Medal of Honor4 / Mayor’s Medal of Honor Nomination Form

You may nominate a person for the Mayor’s Medal of Honor by filling out and submitting the form below or you may also print and mail in this PDF version of the form.

TO ALLOW TIME FOR THE POOL OF POTENTIAL NOMINEES TO GROW, NOMINATIONS WILL NOT BE ACCEPTED IN 2015. CHECK BACK IN 2016 TO MAKE YOUR NOMINATION.

THE NOMINATIONS WILL BE JUDGED BY LAST YEAR’S RECIPIENTS.

Nominee's Name*
First Last
- Male
- Female
Nominee's Phone*
Nominee's Address*
Street Address Address Line 2 City ZIP Code
Nominee's Employer:
Employer's Phone:
Nominator's Name
First Last
Nominator's Phone
How long have you known this nominee?
Nomination for which category? (Chose one or more)*
- Volunteer of the Year
- City Service
- Community-Wide Service
- Services by Senior Citizens
- Challenge Award
- Human Services
- Schools or Education
- Good Neighbor
- Business Owner or Employee
- Mayor’s Choice (Selected by Mayor)
What is the Nominee’s greatest contribution in this category?*
Nominee’s Background Information:
Family
Education
Special Interests
Awards, Recognition and Honors received by your Nominee:
Please describe reasons for nominating your candidate for this award. Let us know his/her outstanding qualities. Give specific examples of the ways he/she serves and shares.*
References
It would be helpful if you could secure brief testimonials from those who have been affected by this Nominee’s efforts in this category. You can upload a scanned copy of the testimonial below. (Please limit to one-page per testimonial. Thank you.)
Testimonial #1:
Accepted file types: pdf, jgp, png, doc, gif, docx, txt, Max. file size: 256 MB.
Testimonial #2:
Accepted file types: pdf, jgp, png, doc, gif, docx, txt, Max. file size: 256 MB.
Testimonial #3:
Accepted file types: pdf, jgp, png, doc, gif, docx, txt, Max. file size: 256 MB.
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Mayor’s Medal of Honor

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444 9th Street, P.O. Box 38
Windom, MN 56101-0038

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Recent Updates

June Fogging ScheduleMay 25, 2023 - 12:36 pm
Proposed Revisions to City Code Land UsageMay 12, 2023 - 3:58 pm
Citywide Cleanup 2023May 4, 2023 - 10:05 am
Did you Know?April 18, 2023 - 3:22 pm
Cancelled – Special Meeting Scheduled for November 22nd at 5:00 p.mNovember 22, 2022 - 9:19 am

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