Name of the person you're nominating (required):

Name of the nominee while attending District 61 (if different):

Grade levels and years the nominee attended District 61:

Nominee's noteworthy activities or accomplishments since attending school in District 61:

Additional information:

Nominee’s contact information (any of the following would be helpful):

Nominee's address:

Nominee's phone number:

Nominee's e-mail address:

Your contact information (optional):

Your name:

Your address:

Your phone number:

Your e-mail address:

May we contact you regarding your nomination?


Is there anyone else you recommend we contact for more information about your nominee?

Thank you for your nomination!