— NOMINATION FORM —
GLOCESTER CITIZEN

If you know a citizen of Glocester who exemplifies the spirit of volunteerism, use the form below to nominate that person for the Town of Glocester Annual Volunteer Recognition Award. The nominee must be a Glocester citizen who donates his or her time in any capacity to the town and its citizens. If you prefer, pick up a hard-copy Nomination Form at the Town Clerk's Office, the Glocester Manton Library, or the Harmony Library. Nominations will be accepted until August 19, 2005.

1. Complete this form
2. Click on the "Submit" button to send by email
   or print the page and mail to Town of Glocester, PO Box B, Chepachet, RI 02814

Person you are nominating:

Address:

Contribution that this person has made to make Glocester a better place in which to live:

Other comments:

Your name:

Your address:

Must be submitted to Town Clerk by AUGUST 19, 2005.