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2. Medal of Character Excellence Nomination Form
   The Medal of Character Excellence Award was established to help recognize the youth of our community for good character.

   Instituted by the Village President and the Community Relations Committee, individuals may be nominated for the award provided they attend a Lombard school and are a resident of Lombard.

   Questions may be directed to the Village Manager's Office, Communications Division, at 620-5718.

   Award nominations are reviewed as needed by the Community Relations Committee. Award recipients are then notified by Village staff and receive their awards at a Village Board meeting.

4. Name of Student:*
6. Age:*
8. School:
10. Grade:*
12. Address:*
14. Phone Number:*
16. Parent or Guardian:*
18. Pillar(s) of Character for which the student is being recognized:

    1. Trustworthiness
    2. Respect
    3. Responsibility
    4. Fairness
    5. Caring
    6. Citizenship
20. Please, state reasons why this student should receive the Character of Excellence award:*
22. Activities outside of school:
24. Name of Nominator:*
26. Relationship to Student:*
28. Nominator's Phone Number:*
30. Once this form is submitted, the nomination will be submitted to the Community Relations Committee for consideration.
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field