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Local
Nomination Form
Nominate someone you know for a local community award. The process is simple.

National
Nomination Form
Nominate a deserving individual for a national award.


Send us a National Jefferson Award nominee. Jefferson Awards are presented annually in four national categories:

Greatest Public Service by an Elected or Appointed Official.
Greatest Public Service by a Private Citizen.
Greatest Public Service Benefiting The Disadvantaged.
Greatest Public Service by an Individual Thirty-Five Years or Under.

Review the list of our past national winners. You will see that they are major history makers and top headline names. If the name is easy to recognize, all we need is the nominee's name and a phrase (15 to 20 words) that supports your reason for the nomination. In the 35 and under category, many names are not nationally known. If the name is not known, give us the nominee's name, address, and contact information as well as a brief paragraph explaining why their work is outstanding.

National Jefferson Awards nomination form.

Step 1 : Nominee information
In this section we require information on the individual being nominateed for a Jefferson Award.

First Name
Last Name
Email Address
Address 1
Address 2
City
State
Zip Code
Home phone number
Work Phone Number

Step 2 : Nominator information
In this section we require information on the individual who is nominating.

First Name
Last Name
Email Address
If you complete the email field you will be sent an email confirming that we have received your nomination.
Address 1
Address 2
City
State
Zip Code
Home Phone Number
Work Phone Number

Step 3 : Choose the award the you are nominating this person for.

U.S. Senator John Heinz Award for Greatest Public Service by an Elected or Appointed Official.

Greatest Public Service Benefiting The Disadvantaged.

S. Roger Horchow Award Greatest Public Service by a Private Citizen.

Samuel S. Beard Award for the Greatest Public Service by an Individual Thirty-Five Years or Under.

Step 4 : Complete the sentence: This individual is nominated for a national Jefferson Award for Public Service because...

Click here if you get an error message.