Dr. Martin Luther King Junior Award Nomination Form

Please be advised that the answers provided in the nomination form you are submitting will be utilized as a key factor in the evaluation of the nominee.

Please provide your (Nominator) Name

Please provide your (Nominator) Email Address

Please provide your (Nominator) Phone Number

Nominee Information

Please provide contact information of the person you are nominating

First Name

Last Name

Is the nominee a resident of Chandler?

Yes

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Please select one nomination category

Dr. Martin Luther King Junior Distinguished Achievement Award

Emma Arbuckle Empowerment Award

Youth Action Award

Dr. King taught that non-violence should be a way of life. Please describe how the nominee’s efforts have addressed four or more of the following core values:

-Non-violence
-Love
-Commitment
-Courage
-Social Justice
-Leadership
-Racial equality

Emma Arbuckle was a community activist who had a strong work ethic, advocated for change and progress, and created opportunities for the community. Please describe how the nominee’s efforts have continued Ms. Arbuckle's efforts in the community.

In what way has the Nominee continued to help to improve the quality of life for all Chandler Residents? Include specific examples over the last 2-3 years.

If you were introducing the Nominee as a recipient of the Award selected above, briefly describe what you would say.

Upload Image of the Nominee

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Dr. Martin Luther King Junior Award Nomination Form