2017 Courage Award Nomination Form
Individual Nominated: _________________________________________________________
Home Address:______________________________________________________________
Phone Number: ______________________________________________________________
Email Address: ______________________________________________________________
I nominate this individual for a Courage Award for meeting the criteria below.
(Please attach a support letter to fully describe why this individual should be honored)
Your Name: _________________________________________________________________
Phone number: ______________________________________________________________
Email: ______________________________________________________________________
How do you know the nominee? _________________________________________________
The Courage award honors Romulus individuals who exemplify courage, kindness, and unselfish
character through their acts of heroism in or out of our community and is defined as the quality of mind
or spirit that enables a person to face difficulty, danger, pain without fear; someone who shows bravery.
Heroes who have saved a life or helped make a life better within the last 15 months can be nominated
by their family, friends, co-workers, neighbors and community.
The criteria for the Courage Award are as follows:
1. An identifiable act or group of acts, which in and by itself clearly demonstrates an act/s
of extraordinary courage or commitment.
2. The act for which the person is being nominated must have brought benefits to the City
of Romulus community.
3. The person must have a strong story and have exemplified the strength of human spirit
by demonstrating one or more the six attributes of courage:
 Feeling fear yet choosing to act
 Persevering in the face of adversity
 Standing up for what is right
 Expanding your horizons & letting go of the familiar
 Facing suffering with dignity or faith
Please return this application along with the letters of support by April 7, 2017 by mailing it to:
Romulus City Hall
ATTN: Hometown Heroes Committee
11111 Wayne Rd.
Romulus, Michigan 48174
We hope this inspires you to participate in the 2017 Hometown Hero Citizens nomination process. Please feel
free to share this information and encourage others. A committee will review all award applications and a
selection will be made based on committee's recommendations. Thank you.