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May
2006
Nomination form for the 2006 Heart and Hands of the Keweenaw Award
Due by June 23, 2006
Send to:
President of the Board
Heart & Hands Award
53044 Hwy M203
Hancock, MI 49930
For more information, call 482-6827 or e-mail us at:
tkinzel@pasty.com.
1. YOUR CONTACT INFORMATION:
Name: _____________________________________________
Phone: _____________________________________________
e-mail: _____________________________________________
Address: _____________________________________________
_____________________________________________
_____________________________________________
2. CANDIDATE’S CONTACT INFORMATION:
Name: _____________________________________________
Phone: _____________________________________________
e-mail: _____________________________________________
Address: _____________________________________________
_____________________________________________
___________________________________________
3. PLEASE ANSWER IN 500 WORDS OR LESS, NO MORE THAN 1-2 PAGES:
How has the candidate or couple had a significant impact on the Keweenaw community
-- giving of themselves in a caring, committed, or heartfelt way in the area of peace, justice, human
needs and/or environmental stewardship? Please be specific about what form their
contribution and involvement has taken.
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