Date: Name of Nominee: City: State: Zip: School: Grade: Daytime Phone #: Evening Phone #: Email Address: Please describe how this person has worked to improve the quality of life in St. Petersburg (100 words or less): Please provide a short biographical history of nominee (100 words or less, including numbers of years of residency, profession, other pertinent history, etc.) Nominated by (self nominations accepted): City: State: Zip: Council District (of residence or place of work): Daytime Phone #: Evening Phone #: Email Address:
