-7 Regular/Item...2011/01/05 · September 7, 201 0 Dear Human Services Advisory Board, The person who I recommend to receive the 20 1 1 M.L.K. Humanitarian award is Mrs. Mattie Allen

MARTIN LUTHER KING JR. HUMANITARIAN AWARD

NOMINATION APPLICATION

DATE APPLICATION SUBMITTED: -7 -- / 6 I YOUR INFORMATION

\,

NAME: C,PPJ~ IL 0 P9'1 NOMINEE INFORMATION

\

NAME: WG I < +I\ +n > -

TELEPHONE NO.: TELEPHONE NO.:

( EMAIL ADDRESS: EMAlL ADDRESS: I

1 YOUR RELRTlONSHlP TO NOMINEE T C . ~ ' / % ~ f l HOW LONG HAVE YOU KNOWN THE NOMINEE: 4 0 Pflf-5 NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE

1 (Please use additional paper as required to cornpjete your submission. Anachments are permissible)

September 7, 201 0

Dear Human Services Advisory Board,

The person who I recommend to receive the 20 1 1 M.L.K. Humanitarian award is Mrs. Mattie Allen. She has lived in Hallandale Beach since the 1950's. I have known Mrs. Allen just about all my life. Mattie Allen is a strong, humble . quiet, and compassionate women. Who is a pillar of the community although many don't know is.

Mrs. Allen was one the first memkrs of Hallandale High School Parents Ad\.lsory Board. '['his active lady was considered a neighbrhood mother is she was always looking out for the children in addition to raising a b u t ten children. As a Hallandale resident she and her W y are well known and respected. For example her late daughter, Mary Allen, a Senior Code Enforcement Oficer worked for the city Hallandale for many years. Her other children are professionals and one is a teacher in the Broward County School system

Mattie Allen can often be seen at community events such as the rededication of Foster Park. She is a faithful choir member of Eknezer Baptist Church and served for many years on the Nurses Guild. Additionally she often serves at fherals and assisting fadies as needed. As working woman with a family to raise Mrs. Allen was a nursing assistant and provided care to many.

Please consider this longtime Hallandale resident for this award. I cannot think of anyone who is more deserving and should be recognized.

Respectfully, Cedric Dean



DATE APPLICATION SUBMITTED: 3 118 (la I YOUR INFORMATION NOMINEE INFORMATION I I . - NAME: bm1k- 1/,&h NAME: hd\~ k @I;bk ADDRESS: '1 [q ADDRESS:

I

V I HOW LONG HAVE YOU KNOWN THE NOMINEE: 5 -b, Lj i ~ i i ? ~

TELEPHONE NO.: ? % ' Slk J o d g TELEPHONE NO.: q5y -,5q P) 8 2 6

NARRATIVE DESCRIPTION O f ACCOMPLISHMENTS OF NOMINEE (Please use additional paper as required to complete your submission. Attachments are permissible)

CLJILLL\~~B- -1 . EMAIL ADDRESS: EMAIL ADDRESS! TIA%-& 5' &-

mi"\

Description of Accomplishments of Nominces

Mark & Ruth Chibis are tireless humanitarians and should be recognized by their community for all their hard work and sacrifices.

Far over 30 years (don't know exactly how many), they started and Ruth has been the nursing super\ isor for The Baby House in North Miami. They house 20-35 severely handicapped children with rcspiratory/phy sical handicaps. There are many nights of life & death traumas, pushing wheelchairs thru Disney World in 95 degrees, VAT camps, etc. Their f rst child in this program, Stefan, who is severely paralyzed w palsy, recently graduated from high school. 'fhcy raised and are currently raising kids, whose parents are not able to take care of them. They sacrifice their own personal time & freedom to center their lives around the kids' schedules and financially and spiritually support them. When old people need handiwork, when divorced families need to move out with no money, when families can't buy groceries, when families are dealing w the death of a loved one, they will magically appear and help or anonymously and tnagically. a Publix gift card will appear. Mark is a rabbi. kvho went to Haiti several times to do relief work and counsel the dying ar~d/or fanli ly members dealing with grief. Ruth is an R.N. nurse, who went to Haiti several times, at a moment's notice, to help the sick and wounded.

Mark & Ruth probably do much more than above mentioned; however, they do it quietly, unbeknownst to all of us. with humor and faith.. ..always encouraging with their kind spirit and words. They are truly one of God's people, and we are lucky in Hallandale Beach to have them as residents.


*.I=-

NOMINATION APPLICATION _ _ .. DATE APPLICATION SUBMITTED: f 2 3

I YOUR INFORMATION l/n

NOMtMEE INFORMAT19N

1 TELEPHONE NO.: (73~), 3 2 3 -,?qf& TELEPHONE NO.:(?) 55 y9-. 5//? EMAlL ADDRESS: 0 6 4 . d EMAlL ADDRESS:

LT c.fi~d9 ,.LO& . YOUR RELATIONSHIP TO NOMINEE: ,rh~/ Ad~jnl : J f z J ~ /Sim~~~ylr

(HOW LONG HAVE YOU KNOWN THE NOMINEE Y ' I ~ ~ / ~ NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE (Please use additional paper as required to complete your submission. Attachments are petm~ssible)

. . . .. - .... . + - .

, . .. -"" THE SCHOOL BOARD OF BROWARD COUNTY, FLBRIDA

*+. - - ,- . &. . A +, - -. . ,. - - , " A , .

C*.? ~* rtb..-r.


NOMINATION APPLICATION t .:

DATE APPLICATION SUBMITTED:

) YOUR INFORMATION NOMINEE INFORMATION

NAME i I

ADDRESS: /f f l 11, 0- bp A

TELEPHONE NO.: ?,{ 9 4 ~ 9 - 4 f l f l f l TELEPHONE NO.: I I I r

I EMAIL ADDRESS: . + EMAlL ADDRESS: YOUR RELATIONSH1P TO NOMINEE: MU IYI -CC

, HOW LONG HAVE YOU KNOWN THE NOMINEE:

NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF N~MINEE (Please use a d d w paper as required to complete your submission. Attachments are permissible)


NOMINATION APPI-ICATION .* - ,- . . - . I ++-- )ATE APPt CATION SUBMITTED: iOUR INFORMATION NOMINEE INFORMATION

TELEPHONE NO. TELEPHONE NO. #2-3~34 EMAIL ADDRESS: EMAIL ADDRESS: [%%!) 4%- t26br

3 , , HOW LONG HAVE YOU KNOWN THE NOMINEE: a\ \ -mv \ i 1

NARRAJNE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE (Please use additional paper as required to complete your submission. Attachments are permissible)

Bertha James has been a fixture in Hallandale for more than 30 years. She was the first African American to own and operate a salon on Pernbroke Road in the 701s, the Beauty Hut Boutique. In 1989 Ms. James along with other pioneering local business owners, Fannie Williams, Laura

Fulton, Pastor leanette Kelly, Rita Mills and Irma Cohens, started the first o f what is now a traditional Martin Luther King Day Celebration at B.F. James Park located off Pembroke Road at NW €lth Avenue. As a member of the Caring and Sharing Ministries at Ebenezer Baptist Church of Hallandale, she helps in preparing the hot meals that are served to the community on Wednesdays and has been presented with several awards from Ebenezer acknowledging her work. She continues to donate her time and facilities for local fund raising.

MARTIN LUTHER KING JR. tUuWA.Li5 BiQcH HLIMANITARIAN AWARD


1 YOUR INFORMATION NOMINEE INFORMATION ADDRESS: 4591 S.W. 19TH STBEET

I WEST PARK, FLORIDA #33023

NAME: LoRaArHE JOKNSON

ADDRESS: 816 N.W. 4Ta A m

HALLANDALE BEACH, FLORIDA 33009

TELEPHONE NO.: (954) 987-2689

EMAlL ADDRESS: None

TELEPHONE NO.: (954) 629-891 7

EMAlL ADDRESS: None

YOUR RELATIONSHIP TO NOM1NEE:

HOW LONG HAVE YOU KNOWN THE NOMINEE:

NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE (Please use additional paper as required to complete your submission. Attachments are permissible]

I Mr. Johnson is a member of Ebenezer Baptist Church and also assist with the -

Food Program by picking up food from Pompano Beach to Florida City. Helps with

preparing and serving hot m e a l s at the church t o Homeless and needy individuals

on Wednesdays. Also distribute bagged food once monthly and every week. An

active Individual in the community. Plus yearly assist w i t h a Rroup of youth on

camping tr ips . and delivers items to the elderly.


NOMINAgI-ION APPLICATION -- ,*. ,. . A

3ATE APPLICATION SUBMITTED: 911 311 0 1Z13

fOUR INFORMATION NOMINEE INFORMATION

YAME: Clara Brown NAME: Lorraine Johnson

4DDRESS: 307 NW 3rd Court ADDRESS: 876 NW 4 Avenue

iallandale Beach, FL 33009 Hallandale Beach, FL 33009

TELEPHONE NO.: 954 678 8921 TELEPHONE NO.:

EMAtL ADDRESS: EMAIL ADDRESS:

YOUR RELATIONSHIP TO NOMINEE: Friend

HOW LONG HAVE YOU KNOWN THE NOMINEE: 50+ Plus Years

NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE (Please use additional paper as required to complete your submission. Attachments are permissible)

Lorraine has been a faithful servant in the Hallandale Beach Communifv for years. He picks-UD food

from Pom~ano to South Miami to feed the needed in Hallandale Beach. He also preDares and serves

hot meals on Wednesdav at Ebenezer Baptist Church. Weekly and monthlv he distributes food to

the hunqw. Every year he takes a aroup of boys cam~inq. He is such a humble man, and does not look

for recoqnition for his exceptional efforts.




I YOUR INFORMATION NOMINEE INFORMATION NAME: NAME:

V '- - - I 1

TELEPHONE NO.^^'^ ?&q216 (, TELEPHONE NO.~S# b d 7 P 7 7 1 EMAIL ADDRESS: EMAIL ADDRESS: -

NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE (Please use additional paper as required to complete your submission. Altachmenfs are permissible)



DATE APPLICATION SUBMITTED: 9-- - / d YOUR INFORMATION NOMINEE INFORMATION

NAME:

TELEPHONENO.: 7~ 3 7 ~ . 79 @ TELEPHONE NO.?S-LJ L; 2 9 F S A 7 I EMAlL ADDRESS: EMAlL ADDRESS: 1 YOUR REiATlONSHlP TO NOMINEE: HOW LONG HAVE YOU KNOWN THE NOMINEE: /o

NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE (Please use additional paper as required to complete your submission. Attachments are permissible)


, - -.



I YOUR INFORMATION NOMINEE INFORMATION I NAME: xi L+ NAME: P W I pce s%

I TELEPHONE ~0.:79 -24 b 76 @ # TELEPHONE NO.: q - u 9 - s I EMAiL ADDRESS: I

EMAIL ADDRESS:

1 YOU!? RELaTlONSHlP TO NOMINEE: ~ Q F [ \ 0 HOW LONG HAVE YOU KNOWN THE NOMINEE: 30

I NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE (Please use additional paper as required fo complete your submission. Aflachments are permissible)

r n r f ~ ; l


NOM I NATION APPLICATION ,km,rrvki j

GCT 2 1 Zfl111 DATE APPLICATION SUBMIlTED: 1 0 + \ - 1

c m of MARTIN LUTHER KING JR. HUMANITARIAN AWARD TTpy

NOMINATION APPI-ICATION I

i4(

I ' DATE APPLICATION SUBMITTED: I I YOUR INFORMATION NOMINEE INFORMATION

TELEPHONE NO.: ? f l - L / S V - f / 3 2- TELEPHONE NO.: C- Y d-~q(- EMAIL ADDRESS: bP3&&;[kQQ*, W f EMAIL ADDRESS:

now LONG HAVE YOU KNOWN THE NOMINEE: ) o 4pu-r s NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE (Please use additional paper as required tc ccmplete your submission. Attachments are permissible)

I

* f hnvl btin a dtilicnttd iqi\nbrr 0 1 t h e OF m %tach community. 21304 + 2Db

NU hdnored +ha+ ml ~ o m m l t m ~ n t to he t~m~rnl h o i ~ Q P Q v~iuj/nized, os avid:ncud by my ruminotio IIY 0 s i t Chmrmun of , th~ GIJ o f Ha11ond41p Bpnchb bmmuni i)i R ~ l a i ~ oni Comw 1 thu, my orpintmtnt t c i h t u i Hallsndait B @ Q L ~ P R V K ~ ~ n d R Q C Y ~ Q ~ O ~

b o a r d , tht I O C ~ CY\VIC WiliCh b r c l of iuectous, -the School Advl~ai forum. und rnort.

d 2 R i i n H I : :m c r n m i i i r i i minus9 ii m j bdifio oi piiblic ;i~rvite U S a Youth 6 t ~ ~ e * .Cooudino,bu.

I t # Cuvvtnt\~ a board m~u\iibsf OF t h e W e ~ d nnc\ Seod tommi itl e a . h a Q \ ~ O N o n ~ d ~ t e J -!OR%[ ~~a~~ketr~btdq~

$ h i \ ~PRYI of Sthm\ Mvbor Caun~e\or SK nnd 4 8 Y Y \ Stha / (~VIIOI Form ( S H F ) ~ iia\\unda\c Mlgh+ S b ht pas\ i yrars, ?: hlrvv bun i h s ChapIin & , $ i/\t i/a\\nnda\~ Sihuu\ h\iimoi tssoiint~an. * . + I 'm m ordninad dcocljn nt ii~cjhr~ Viwn

Min\it~i~s fo r \ o y (nu ; rasponsi b\ e fvv ovcru@ and - b e m~\h iC m\n\str . 4 + . 'm \\~olha ck\uiyman of d e r n ~ n ? ~ m\nistr

a\ ~ighar Viiicn Nin\i\ui!i. Y rnlfliwi younc\ mm nnR voluntc~r ~[t E Q ~ I C J

win^ 3 D ~ v d ~ ~ m ~ n i Ctaior in +hi tiy c f iiniianddr. I3flch nk- J b t ~ !mpioy !d [,iy I r - taf A . ~ - I ~ - I I ~ Z > *,

# o ; l c a -. \ i~uf i ; \ ! \~&\ 'J~ *



DATE APPLICATION S U S M I ~ D :

YOUR INFORMATION NOMINEE INFORMATION

I I ,..,:FA,L~ 04, i rp r3 NAME:

(TELEPHONE ~ 9 ) ~ TELEPHONE N O q- EMAIL ADDRE&.\ qg+2~7,4n gO EMAIL ADDRESS: n I ~ ~ ~ Y L . W B

Q @ I n c ~ YOUR RELATIONSHIP TO NOMINEE:

HOW LONG HAVE YOU KNOWN THE NOMINEE: S ~ e o - r 5 NARRATIVE DESCRIPTION OF ACCOMPLlSHMENTS OF NOMINEE (Please use additional paper as required to complete your submission. Attachments are permissible)


NOMINATION APPI-ICATION I

DATE APPLICATION SUBMITTED: / ~ / u / / o

I YOUR INFORMATION NOMt NEE INFORMATION I

e. 3=L&a& NAME: Ad pen 4 ; r F h

I ADDRESS: . Y ~ / ~ & - ~ S ~ , ~ L , ADDRESS: c.; c, N,+JL B- k A p e , /d/

r

TELEPHONE NO.: s ~ . r -uru -0 d6o TELEPHONE NO.:

EMAlL ADDRESS: dp--a am;( .a? EMAlL ADDRESS: YOUR RELATIONSHIP TO NOMINEE: s r r ; - 3-& ), ;S b d - 4 c A , L r - h i p /


NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE (Please use additional paper as required to complete your submission. Aflachmenfs are permissible)

& MARTIN LUTHER KING JR. ALLAMDALE BEACH c$y Ifc*

HUMANITARIAN AWARD

NOMINATION APPLICATION - i--

DATE APPLICATION SUBMITTED: 0 YOUR INFORMATION NOMINEE INFORMATION

(NAME: { D ~ I L ir) TL cpc-5

L I 394 -.3!ps)i( TELEPHONE N O . : ( ~ X L ) ~ ~ S - ~ S X . \ TELEPHONE NO.: 5 5 ) O, a r r T O 5 Q

EMAIL ADDRESS: qrdwo . cam EMAIL ADDRESS: YOUR REuTloNsH\P To NOMINEE: - C C R LL,~ - ? r d 5 , ~ f l f i +

1 HOW LONG HAVE YOU KNOWN THE NOMINEE: NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF N~MINEE (Please use additionaj paper as required to complete your submission. Attachments are permissible)



DATE APPLICATION SUBMITTED: 10 /I, /a I,, 1 /

I YOUR INFORMATION NOMINEE INFORMATI0 W I NAME: x*mhTw(

J / FJq [qL3 +ir, /J I m m ~ s s 4 kl(p~ AoonEss: :1,[3(3 i~ w 1 - 5-l 1

-- ~ Q - ) 5- 63%) - TELEPHONE NO.: (7.731) Ll T? 5) TELEPHONE NO.:- / EMAIL ADDRESS: EMAIL ADDRESS: 1 YOUR RELATIONSHIP TO NOMINEE:

I HOW LONG HAVE YOU KNOWN THE NOMINEE: NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE 1 (Rcasa use rddilisnai paper as renured l a cornpie& your rudrnlrrion Attachmend eie prmbilb/e)


NOMINATION APPLICATION r C ' r C f '

1 f , , -

DATE APPLICATION SUBMITTED: 10 - - TL' ' YOUR INFORMATION NOMINEE INFORMATION 1 1

1 NAME: ' 1 ,,q , A .

ADDRESS: b'c

/wdlm(r.&k B A J A . / 8.4-n 3 3 8 33~85' -

TELEPHONE NO.: @s/ TELEPHONE NO.: EMAIL ADDRESS: EMAIL ADDRESS: n

.--j / n

YouR RELATIONSHIP To NOMINEE: 4 a;&rld HOW LONG HAVE YOU KNOWN THE NOMINEE: ,/?/I P'pf ; NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE (Please use addit~on as required to complete your submission. Attachments are permissible)

ylAdAd/ \



1 DATE APPLICATION SUBMITTED: / b - ? - 7 a 1 YOUR INFORMATION NOMINEE INFORMATION

/ NAME: s L ~ A L / ~ L ~ IADDRESS: 7 4 6 /*/L. 7f $st- ADDRESS: 50 9 d t ~ FOPF~T .~ 1

1 TELEPHONE NO.: TELEPHONE NO.: 1 EMAIL ADDRESS: EMAl t ADDRESS: I YOUR RELATIONSHIP TO NOMINEE: HOW LONG HAVE YOU KNOWN THE NOMINEE: 9 5 Yt NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE (Please use addttional paper as required to complete your submission. Attachments am petmissible)

MARTIN LUTHER KING JR. HLIMANITARIAN AWARD



1 YOUR INFORMAT~ON NOMINEE INFORMATION

EMAIL ADDRESS: I YOUR RELATIONSHIP TO NOMINEE:


NARRATIVE DESCRIPTION OF ACCOMPL1SHMENTS OF NOMINEE (Please use additional paper as required to complete your submission. Attachments are permissible)


NOMINATION APPI-ICATION


I YOUR IMORMATION NOMINEE INFORMATION NAME:

1 TELEPHONE NO.: 75 L1-423 d2 5 TELEPHONE NO.: 76+*923-2157 (EMAIL ADDRESS: EMAIL ADDRESS:

1 1 HOW LONG HAVE YOU KNOWN THE NOMINEE: a 3 \lr! NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE (Please use additional paper as required to complete your submission. Attachments are permissible)

MARIDIN LUTHER KING JR. HUMANITARIAN AWARD

NOMINATION APPI-ICATION

NOMINEE INFORMATION

N A

33- TELEPHONE NO.: 'I S q -373 -&A3 TELEPHONE NO.: EMAlL ADDRESS: EMAtL ADDRESS:

YOUR RELATIONSHIP TO NOMINEE:

I 1 HOW LONG HAVE YOU KNOWN THE NOMINEE: %'/a y rs . I I NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE ( (Please use addifionakaper as required to complete your submission Aiiachrnents are permissible)

f -cniv MARTIN LUTHER KING JR. =4LLLVDALE B m C H cgy 4 f C k

HUMANITARIAN AWARD

NOMINATION APPLICATION 1 - DATE APPLICATION SUBMITTED: &

L

- /ilb TELEPHONE NO.: TELEPHONE NO.:- I

EMAlL ADDRESS: EMAIL ADDRESS:

YOUR RELATIONSHIP TO NOMINEE:

HOW LONG HAVE YOU KNOWN THE NOMINEE: I IPTION OF ACC paper as required


I city ofchoke NOMINATION APPLICATION

DATE APPLICATION SUBMITIED: - I NOMINEE INFORM.ATIOFJ j 1

ADDRESS:

TELEPHONE NO.: I EMAlL ADDRESS: EMAIL ADDRESS:

r * d' d ,hhly IYOUR RELATIONSHIP TO NOM1NEE: , '//? -- HOW LONG HAVE YOU KNOWN THE NOMINEE /?w /f Y ~ J -

f

) NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE I chrnents aye permissibk) /

J -



I DATE APPLICATION SUBMIlTED: NOMINEE lNf ORMATION

I TELEPHONE NO.: TELEPHONE NO.: I EMAIL ADDRESS: EMAlL ADDRESS: -

YOUR RELATIONSHIP TO NOMINEE: I

HOW LONG HAVE YOU KNOWN THE NOMINEE: \ / 1-5 7

NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE I (Please use additional paper as required lo compIele your submission. Anachments ere permissible) I



/?//(h? DATE APPLICATION SUBMIITEDd NAME:

/TEEPnoNE No-: TELEPHONE No.:

I EMAIL ADDRESS: &MIL ADDRESS: I HOW LONG HAVE YOU KNOWN THE NOMINEE: u*

NOMINATION APPLICKrION


DATE APPLICATION SUBMITTED: 1 ~ ? \ , 4 ! 1 ~

NAME:

J30~1'i


1 EMAIL ADDRESS: I EMAIL ADDRESS: _ 1

HOW LONG HAVE YOU KNOWN THE NOMINEE: -

NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE use additional paper as required



DATE APPLICATION SUBMITTED: 18 - / q- 1 0 YOUR INFORMATION NOMINEE INFORMATION


I EMAIL ADDRESS: EMAIL ADDRESS:

NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE (Please use additional paper as required to complete your submission. Atfachmenfs are permissible)



DATE APPLlCATlON SUBMITTED: d 0 // c / I YOUR INFORMATlON NOMINEE INFORMATION

ADDRESS: 3% 4 ' ~ ~ 146 fi~k& I-;- ( 1 9 k d c, (F

1 TELEPHONE NO.: TELEPHONE NO.: (EMAIL ADDRESS: EMAIL ADDRESS:

I


NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE (Please use additional paper as required to complete your submission. Attachments are permissible) -

C~ A c A & t ~ , u , W ~ I A+A- Y f i d !

- =\, G ~ ~ R ~ . + ~ I ' P ~ ~ 4hk ( - A & a/d m,, /l.(

I

/ hki ~auhI-7


NOMINK170N APPLICATION

DATE APPLICATION SUBMITTED: , t, 1 , j; 1:: NOMINEE INFORMATION , I

ADDRESS: 01~) ADDRESS:

TELEPHONE N0.1:75-#) 423 ~ l h 2" TELEPHONE NO.: I EMAIL ADDRESS: EMAIL ADDRESS: i

HOW LONG HAVE YOU KNOWN THE NOMINEE: =11/11 3

NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE are permissible)

t I '


DATE APPLICATION SUBMITTED: / f i & / G NOMINEE INFORMATION

NAME:

&-% -& ADDRESS: 56 l / Q j!fd$il&.&,w. 1 1 , 5 3 069

TELEPHONE NO.: (- 3 01;) 3/2-9092 TELEPHONE NO.: I EMAlL ADDRESS: EMAIL ADDRESS:

HOW LONG HAVE YOU KNOWN THE NOMINEE: / 5 @- NARRATlVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE

I (Please use additional paper as required to complete your submission. Attachments are permissible)



DATE APPLtCAT1ON SUBMITTED:

1 YOUR INFORMATION , NAME:

I ('

NOMINEE INFORMATION

r-.

NAME: S / I ~ J A / ~ d i k K ~ ADDRESS:


I EMAIL ADDRESS: m,-8~f$~ ~lf/rlL+MAlL ADDRESS:

1 HOW LONG HAVE YOU KNOWN THE NOMINEE: 20 q.fs. NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE (Please use additional paper as required to complete your submiss~on. Attachments are permissible)



DATE APPLICATION SUBMITTED: 4 , / //L) I YOUR INFORMATlON NOMINEE INFORMATION

q t i d 0 NAME: 3 cuva rc+ ($; C L5

I

u.4 - / TELEPHONE NO.: ?S 9- qn-9 ~ X A TELEPHONE NO.:

I EMAIL ADDRESS: EMAIL ADDRESS:

NARRATIVE DESCRIPTION OF ACCOMPLISHMENTS OF NOMINEE (Please use addlijonal paper as required to complete your submission. Attachments are permissible)




( YOUR INFORMAT ION NOMINEE INFORMATION I NAME: \ G cLA~ NAME:s\n ADDRESS: - ADDRESS:

1 HOW LONG HAVE YOU KNOWN THE NOMINEE: &k O& 1 ; GI 1 NARRATIVE DESCRlPTlON OF ACCOMPLISHMENTS OF NOMINEE

paper as required to complete yo 1

Documents

-7 Regular/Item...2011/01/05 · September 7, 201 0 Dear Human Services Advisory Board, The person who I recommend to receive the 20 1 1 M.L.K. Humanitarian award is Mrs. Mattie Allen