Honoree Nomination Form

Office of Hispanic Affairs

Nominations for each event must be submitted no later than ten days prior to the event date.

Thank you for taking time to nominate a Nassau County Resident or Business owner to be recognized by Nassau County. Your nomination helps us celebrate the diverse talents and contributions that enrich our county. Please fill out this form with details about the nominee and your reasons for nominating them. All nominations will be reviewed by a selection committee.

All fields marked with a red asterisk (*) are required

Your Information (Nominator):

First Name: *

Last Name: *

Phone: *

Email: *

Event Information:

Event Name: *

Event Date: *

Nominee Information:

Nominee First Name: *

Nominee Last Name: *

Address: *

City: *

State: *

Zip Code: *

Nominee Phone: *

Nominee Email: *

Nomination Details: *

Why do you believe this nominee should be recognized by Nassau County? (Please provide a detailed explanation including any achievements, contributions to the community, or other reasons that make this nominee stand out.)

Consent and Declaration: *

I hereby confirm that the information provided in this nomination form is accurate to the best of my knowledge. I understand that the county reserves the right to verify any information provided and that submission of this nomination form does not guarantee selection.

I acknowledge and agree to the consent and declaration *