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HARRIMAN ROTARY NOMINATION FORM

Outstanding Community Leader Award

This award is given quarterly by the Harriman Rotary Club to an individual who has displayed exemplary leadership in the betterment of the Roane County Community and one who's life personifies the Rotary Four Way Test. This form must be completed by a Harriman Rotarian.

After completing the form, please return to the Harriman Rotary President. All forms received will be reviewed by the Harriman Rotary Board of Directors, who will select the winner and make a decision at least three weeks prior to the notification of the award. Once the selection has been made, the Rotarian who submitted the nomination will be asked to contact the nominee and identify a Rotary meeting in which the award can be presented.

• Name of Rotarian completing this form _______________________________________
  
  
• Date__________________________
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• Name of Nominee ________________________________
  
  
• List and describe community activities this individual has been involved in: