Note: Copies and recreations of this form will be accepted.

Date:__________________

Nominator Information*:

Individual Name: ______________________________________________________
Partner Organization: ____________________________________________________
Street: ______________________________________________________________
City: ______________________________     State: ________     Zip:__________
Office phone: (____)_____________ Home phone: (____)_____________________
Fax: (____)____________ Email: _________________________________________

If the nominee is selected may we contact you for materials related to the nominees work (newsletters, articles, photographs, etc.)?     yes__ no__

May we share the nomination packet with the nominee?     yes___  no___

If the nominee is selected, who would you suggest to present the award at the Heroes Banquet? The presenter should be someone attending the River Rally who is familiar with the Hero and able to give short speeches. River Network staff are not eligible to make award presentations - though they are quite capable of short speeches.

Name/Contact Information:______________________________________________ _____________________________________________________________________ 

*Nominations must be submitted by individuals affiliated with a River Network Partner. This can include staff, board, members and volunteers of River Network Partner organizations. However, River Network board and staff are not elibigle to submit nominations or letters of support.

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River Hero Nominee

Nominee’s Name: __________________________________________
Nominee’s Title:___________________________________________
Organization: _____________________________________________
Street: ___________________________________________________
City: _____________________    State: ________     Zip:___________
Office phone: (____)_____________ Home phone: (____)___________
Fax: (____)____________ Email: ______________________________

My relationship to the nominee is: ______________________________

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Requested Application Materials

In addition to the above information, please provide the following by the stated deadline:

1. No more than three (3), single-sided 8.5” x 11” type-written pages describing:

• The nominee’s background  - as it relates to river conservation
• General background information concerning the river/watershed of interest (e.g., size; type; water uses/users; unique features/interesting facts; etc.)
• The event, program or project for which the nominee deserves recognition...focusing on his/her specific role/involvement 
• The measurable results of the event, program or project
• The overall contribution the nominee has made to river conservation movement

2. Three (3) Letters of support

The top of each letter must clearly identify the name of the nominee. Each letter should provide the supporter’s contact information and their relationship to the nominee and specifically address the ways in which the nominee meets the River Hero criteria. When possible, letters of support should not be mailed separately; the letters should be included as part of the nomination packet submitted to River Network.

Questions or Comments About River Heroes?

Contact Katherine Luscher (kluscher@rivernetwork.org); 503/542-8384