ULSTERCOUNTY

OFFICE FOR THE AGING

1003 Development Court Anne Cardinale, RN, GCNS-BC

Kingston, NY 12401 Director

Ulster County Website: Ph: 845-340-3456

MICHAEL P. HEIN Fax: 845-340-3583

CountyExecutive

2014 SENIOR CITIZENS OF THE YEARNOMINATION FORM

Each year the Office for the Aging Advisory Council join County Executive, Michael Hein, and OFA Director, Anne Cardinale, in selecting the Senior Citizens of the Year Award and the Outstanding Contribution by a Senior Citizen Award.

Annually,we select two extraordinary senior citizens who have made significant contributions to enhance the lives of residents within their community. The nominations are for seniors age 60 and older. Nominations are welcome from any group or individual.

In order to have enough time to fairly and thoroughly review nominations, we are requesting all submissions be made by March 31, 2014. Please return this nomination form to the UlsterCounty Office for the Aging. If you have any questions,call the Office for the Aging at

#845-340-3456 or toll free at #1-877-914-3456.

Name of Person Making Nomination:______

Phone Number:______

WHY DOES THIS PERSON DESERVE SPECIAL RECOGNITON?

PLEASE BE SPECIFIC (Use additional paper if needed)

2014 Senior Citizen of the Year Award
The Senior Citizen of the Year Award is granted to a senior citizen who has tirelessly advocated on behalf of seniors within their communities, or has assisted in providing needed support services and activities which have enhanced the lives of others in their community. Our nominee for Senior Citizen of the Year is:
NAME: ______
MAILING ADDRESS:______
PHONE: ______DATE OF BIRTH:______
PLEASE LIST ON AN ATTACHED SHEET THE ACTIVITIES, ACHIEVEMENTS AND REASONS THAT YOU FEEL OUR NOMINEE SHOULD RECEIVE THIS AWARD.
2014 Outstanding Contribution by a Senior Citizen Award
The award for Outstanding Contribution by a Senior Citizen is awarded to a dedicated senior who has through one or more acts, made outstanding service to their community. They are examples of the power of volunteering and working to make our neighborhoods a better place to live. Our nominee for Outstanding Contribution by a senior citizen is:
NAME:______
MAILING ADDRESS:______
PHONE: ______DATE OF BIRTH:______
PLEASE LIST ON AN ATTACHED SHEET THE ACTIVITIES, ACHIEVEMENTS, AND REASONS THAT YOU FEEL YOUR NOMINEE SHOULD RECEIVE THIS AWARD.

PLEASE DELIVER OR MAIL COMPLETED FORM TO:

ULSTER COUNTY OFFICE FOR THE AGING

1003 DEVELOPMENT COURT, KINGSTON, NY 12401

*ALL NOMINATIONS MUST BE RECEIVED NO LATER

THAN MARCH 31, 2014