Lions Club of Kitchener

Nominations for Citizen of the Year 2011 are open from January 2nd to March 17th 2012.

Nominate a Citizen of the Year!

Simply fill in the following form, click submit, and your nomination will be sent electronically. Or you can mail your nomination to the address our Contact Us page. For web submissions please mail supporting documentation to the club address listed on our Contact Us page.

Your Information First Name Last Name Mailing Address City Province Postal Code Phone # E-Mail

Nominee Information First Name Last Name Mailing Address City Province Postal Code Phone # E-Mail

List the Charities and Organizations that the nominee is involved with along with the years of service for each.
Reason for Nomination

Lions Club Of Kitchener

Nominate a Citizen of the Year!

Supporters