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MLK Diversity Awards Nomination Form

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21st Annual City of Tempe 
Human Relations Commission

MLK Diversity Awards

Deadline for nominations:  Wednesday, December 5

Winners will be honored at the annual City of Tempe MLK Diversity Awards on

Monday, January 14, 2019
8:00 a.m.
  The Marriott Buttes Resort

Eligibility Requirements:

  • Nominee must demonstrate a commitment to the promotion and acceptance of diversity in Tempe
  • Individual nominees must live, work, or volunteer in Tempe.  Business/Organization nominees must be located in Tempe.  Diversity Supplier nominees do not need to be located in Tempe, but must have done business with the City of Tempe in 2017.
  • Current elected officials and current Human Relations Commissioners are not eligible for nomination.
  • Past award winners will be eligible after three years for a new or different project. 


1

This nomination is for the following category (select one)

This nomination is for the following category (select one)
2

Name of Nominee:

 *
3

Nominee's Address

 *
Nominee's Address
4

Nominee's Phone Number:

 *
Nominee's Phone Number:
5

Nominee's E-Mail:

 *
6

Describe why this individual/organization exemplifies a commitment to diversity in the City of Tempe:

 *
7

Describe how the individual/organization's efforts have addressed these following characteristics that exemplify the spirit of Dr. Martin Luther King, Jr.  (Please select three characteristics to write about)

Describe how the individual/organization's efforts have addressed these following characteristics that exemplify the spirit of Dr. Martin Luther King, Jr. (Please select three characteristics to write about)
8

Describe any challenges that this individual overcame in implementing these activities/accomplishments:

9

Additional Comments that Support the Nominee:

10

References:

References:
11

Nominator Information:

 *
Nominator Information:
  1. To receive a copy of your submission, please fill out your email address below and submit.
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