McHenry Area CHARACTER COUNTS Form

McHenry Area CHARACTER COUNTS! Coalition
Character Recognition Program
Citizen of Character Nomination Form
To Submit: Save Form and Email to [email protected]
or mail to Cindy Witt
City of McHenry
333 South Green Street
McHenry, IL 60050
Purpose
The purpose of this program is to create a means to raise awareness of the importance for those in our community to live their lives observing
the six pillars of character and to recognize those who exemplify the pillars in their deeds around the community. Citizens or officials from
local organizations and municipalities can nominate those in our community who demonstrate the six pillars of character in their daily lives
and deeds by submitting a nomination form to the McHenry Area CHARACTER COUNTS! Coalition.
Nominee Information
Nominee Name:
School or Organization:
Parent Names (if a student):
Nominee Address:
Please describe in detail the reason for the nomination. Please be sure to describe the specific pillar (s) that
the nominee exemplifies:
Contact Information of Person making Nomination
Contact Name:
Contact Title:
Contact School or Organization:
Contact Phone:
Contact E-mail:
Character Counts! Recognition Certificate
The CC! Coalition will recognize those who are nominated for extraordinary acts of character in their daily life with a CC! certificate that will be
presented by a member of the coalition.
Character Counts! Recognition “Six Pillars” Recognition Plaque
The CC! Coalition will recognize those who are nominated for uncommon acts of character in their daily life with CC! plaque that will be
presented by a member of the coalition at a City Council Meeting. Those individuals who receive the McHenry Areas CC! Coalition Six Pillars
Plaque will be recognized as a group during the annual Fiesta Days celebration.