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Young Citizen of the Year Nomination Form

  1. Nominee Name
  2. This year Wall Township will be naming a Young Citizen of the Year. The award recognizes an individual with outstanding leadership and citizenship in the community.

  3. *The information in this section is considered personal information, and is therefore deemed confidential for the purpose of P.L. 1963, c. 73 (C.47:1A-1 et seq.) and P.L. 2001, c. 404 (C.47:1A-5 et al.).

  4. *The information in this section is considered personal information, and is therefore deemed confidential for the purpose of P.L. 1963, c. 73 (C.47:1A-1 et seq.) and P.L. 2001, c. 404 (C.47:1A-5 et al.).

  5. *The information in this section is considered personal information, and is therefore deemed confidential for the purpose of P.L. 1963, c. 73 (C.47:1A-1 et seq.) and P.L. 2001, c. 404 (C.47:1A-5 et al.).

  6. Please list all extracurricular activities participated in by nominee.

  7. Please list all volunteer hours and experiences participated in by nominee.

  8. Leave This Blank:

  9. This field is not part of the form submission.