HERITAGE & UNITY Award Nomination Form

The Hmong Heritage Month Planning Committee is looking for outstanding, qualified individuals and organizations or businesses who display exemplary passion and dedication to the growth, support and unity of the Hmong population and the Central Wisconsin community. They must demonstrate appreciation for the Hmong traditions and customs through collaborative efforts in the community.
*Nominees must reside in central Wisconsin*

There are 4 categories. Select the one that applies. Business or Organization Non-Hmong individual Adult Hmong Individual (19+ years old) Youth Hmong Individual (18 years old and under)

Deadline for submitting nominations is March 22, 2013

Nominees Name:______________________________________________________________
Address:____________________________________________________________________________ Phone:_________________________________ E-mail:____________________________________

Nominators Name: ___________________________________________________________________ Address:____________________________________________________________________________ Phone: ________________________________ E-mail:____________________________________

Please type and attach the responses to the following questions: 1. What makes the nominee the best candidate for the Unity award? 2. What has the nominee done to promote, address or contribute to the unity of the HmongAmerican population and the central Wisconsin community? Please identify specific projects or activities.

Please return this form and your responses to: Hmong Heritage Month Planning Committee 1109 Sixth Street Wausau, WI 54403 or email to hmongheritagemonth@gmail.com For additional information, contact Yeng Vang at (715) 570-1630 or yeeb.vaaj@gmail.com.