Citizen of the Month Nominations

Our community has benefitted over the years through the efforts of special residents in the City of Watervliet who donate their time and energy undauntedly. The Council has determined that these individuals should be recognized. One individual monthly will be presented the CITIZEN OF THE MONTH AWARD by the Council, at the last council meeting of each month.

To nominate someone who you believe deserves this recognition, please complete the application attached and submit it. All applications will be reviewed by a volunteer selection panel and you and the honoree will be notified.

GUIDELINES FOR MAKING NOMINATIONS:

ELIGIBILITY:
1. Verified past or present resident of the City of Watervliet
2. History of exemplary citizenship
3. Individuals only (includes youth, seniors, veterans, volunteers, etc.)
4. Must have given extraordinary personal resources resulting in observable improvements in character, rank, position, or achievement to the City of Watervliet as a place to live, work, or play.
NON-ELIGIBLE PERSONS:
1. Current elected officials
2. past elected officials four (4) years immediately following completion of their last elected term
3. Paid staff
4. Paid contractors
Application must be complete and submitted by 3:00pm on the 1st of each month. Nominations may be submitted via the online form or a printable PDF filled out and returned to my office at city hall.

City Hall – Mayor’s Office
2 Fifteenth Street
Watervliet, NY 12189
Cpatricelli@Watervliet.com

Download Fillable PDF

Nominee Information

Nominee Name:

First Last

Nominee Address:

Street Address City State / Province / Region ZIP / Postal Code

Nominee Phone Number:

Nominee Email:

Nominee's time period of residency in Watervliet:

At address:

Sponsor Information

Name

First Last

Sponsor Address

Street Address City State / Province / Region ZIP / Postal Code

Sponsor Phone Number

Sponsor Email

Identify the contribution(s) made by Nominee:

Describe how contribution affected the City of Watervliet:

List two Watervliet residents as references (Supply addresses and phone numbers):

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Phone

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