HERO CATEGORIES: Select One

NOMINATE A LOCAL SALT LAKE COUNTY HERO

We as a community, looking forward to the future and realizing the extraordinary contributions that we can all make, should be excited when others are given opportunities to reach their full potential. Because when they do, we all benefit, and that’s what diversity and inclusion represents.

HERO CATEGORIES: Select One

Salt Lake County Local Hero oftheYear

Salt Lake County Senior Hero oftheYear

Salt Lake County Youth Hero of theYear

CRITERIA: Share specific details how your Hero contributes to the community locally, nationally or globally, how they are an inspirational role model and how they demonstrate excellence in their personal or professional field when answering the questions.

Addresses the problems we seek to confront, the issues we want to highlight and theideas we choose topursue

An inspirational role model for the Salt Lake Countycommunity

Demonstratesexcellenceintheirpersonalorprofessionalareaofcommunityservice

Encourages goodcitizenship

Significant contributor to the Salt Lake Countycommunity

If selected, local heroes must attend the DiversityDinner

Hero Contact Information:

Name:

Address:State:Zip:

Phone:Email:

1.How has your Hero gone “above and beyond” to help others? Please provide specific examples.

2.In what ways will the lives of specific individuals be bettered because of your Hero’s community involvement? Please identify the groups of individuals and how many liveswill beimpacted.

3.Is there a specific event or turning point that inspired your Hero to volunteer and give back to thecommunity?

4.Please describe your Hero’s community involvement, such as volunteer work or outreach. Please be as specific as possible (e.g. number of people helped, number ofvolunteer hours).

5.What challenges are evident in our community and how does your Hero contribute to proposedsolutions?

6.What has changed or is different in the Salt Lake County community because of your Hero’s goodworks?

7.What legacy does your Hero hope to leave through theircommunity involvement?

8.What organizations (schools, 501(c)(3) organizations, churches or other religious institutions, etc.) does your Hero workwith?

9.What specific outcomes has your Hero made possible?

10.Who or what inspired your Hero to give back toour community?

11.Why does your Hero deserve recognition as a Community Hero? Please describe what he/she has done to help make the Salt Lake County Community a betterplace.

Who else would support this nomination or be able to provide additional information?

Nominator:

YourName: Address: City: State: Zip: Phone: Email:

Supporter:

Name: Address: City: State: Zip: Phone: Email:

The finalists will be recognized at the annual Mayor’s Diversity Dinner at the Utah Cultural Celebration Center.

Register to attend the Diversity Dinner at slco.org/diversity

Mail or Email submissions along with a photo of the Hero by September 30 to:

Emma E. Houston, Director of Diversity & Inclusion Office of the Mayor

Salt Lake County GovernmentCenter 2001 South State Street – N2-100 Salt Lake City, Utah84190

Email: