2023 Local Government Hero Nomination Form

Your First & Last Name *

Your Email Address *

Providing you email address give LAGERS a point of contact for your nomination.

Your Phone Number *

Please provide your phone number as an addtional point of contact for your nomination

Your Local Government Hero Nominee *

Please provide their first and last name.

Your Hero's Job Title or Position *

Your Hero's Place of Employment *

The nominee must be employed by a LAGERS covered subdivision.

Your Hero's Phone Number *

Your Hero's Email Address *

Why is this person your choice for LAGERS Local Government Hero *

You my upload a word document below, if you’d like. Please be sure type “upload” in the field above if you choose to upload.

Upload Your Hero's Nomination

Click or drag files to this area to upload. You can upload up to 3 files.

You may upload your nominees information instead of giving your explanation for why you are nominating this individual.