HCC’s “Saluting Our Local African-American Heroes” award

Please complete the form below and submit it along with an essay that addresses each of the following four qualities that are used as the selection criteria. The narrative should expand and focus on specific examples that demonstrate the nominee’s commitment and unique contributions to the Roanoke Valley. Any citizen of the African-American community is eligible to be considered for this nomination.

The narrative should describe the nominee’s qualities in the following areas:
1. Commitment and contributions to the community.
2. Unselfish devotion to others.
3. Initiative, innovation and leadership in the region.
4. Willingness to share time and wisdom through service to the community and its citizens.

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1. Name of Nominee

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2. Address of Nominee

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3. Phone Number / Email Address of Nominee

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4. Nominee's Job Title and Employer

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5. Name of Person Completing Form

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6. Phone Number / Email Address of Form Completer

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7. Write an essay addressing the four qualities described at the top of this survey for full consideration of your nominee by the awards committee. If you have questions, contact Melanie Temple at (252) 538-4319 or e-mail her at templem@halifaxcc.edu. Thank you for your participation!