Name of Nominee # of Years as a Yorba Linda Resident
Address City State
Zip Code
Home Phone
Cell Phone Email Address
Name of Nominator Relationship to Nominee
Address City State
Zip Code
Home Phone Cell Phone Email Address
In no more than one page, please describe the nominee's exceptional qualifications for the award and the
nominee has made a significant positive impact in the City of Yorba Linda and community at large. Please include all
volunteer clubs, and organizations that the nominee has been involved in and any special
achievements or honors. can include information below or may attach your own page to the nomination
City of Yorba Linda
CITIZEN OF THE YEAR 2020
Nomination Form
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| City of Yorba Linda 4845 Casa Loma Avenue, Yorba Linda, CA 92886 714-961-7100
yorbalindaca.gov
Since 2004, the City of Yorba Linda has honored a member of the community who provides uncommon and
outstanding volunteer service, devoting his or her time and talent to making our community a better place to live
and work through the Citizen of the Year recognition. Please help us honor our local heroes whose selfless
dedication to serving others stands as the ultimate example for all of us to follow.
NOMINEE INFORMATION
NOMINATOR INFORMATION
NOMINATOR INFORMATION
NOMINATOR INFORMATION
SUMMARY OF CONTRIBUTIONS