CITY OF SAN DIMAS
2021 OLDER AMERICAN HONOREE
NOMINATION FORM
Every year the Los Angeles County Board of Supervisors and the City of San Dimas proclaim May as Older American
Recognition Month. Nominations for the San Dimas Older American Honoree are reviewed by the Senior Citizen
Commission and the selected Honoree is recommended to the San Dimas City Council for final appointment. The San
Dimas Older American Honoree represents the City of San Dimas at the Los Angeles County Older American Recognition
Day celebration.
The San Dimas Older American Honoree must meet the basic criteria with emphasis placed on service to the community
of San Dimas. See the reverse for a sample honoree biography as well as a list of previous San Dimas Older American
Honorees.
Basic Criteria:
1. Nominee must be at least 60 years of age at time of nomination.
2. Nominee must be active in City of San Dimas.
3. Nominee must be a resident of San Dimas.
1. Name of Nominee: Phone:
Address: City: Zip:
Birthdate of Nominee: / /
Month Day Year
2. NOMINATION STATEMENT – Please state your reason for nominating this person for San Dimas’ Older American
Honoree describing their involvement in the community. Also, include brief biographical information. Attach
additional pages if needed. Please be as descriptive as possible.
Your Name: Phone:
Address: City: Zip:
Nominations must be submitted to the
San Dimas Senior Citizen/Community Center,
201 East Bonita Avenue, no later than 4:30 p.m. on Friday, February 19, 2021.
Please contact us at (909) 394-6290 if you have questions or need additional information.
