Kenworthy Nomination Form

The recipient of this award will be selected based on the following criteria: 

  • Commitment to Leadership Springfield
  • Involvement in community service activities
  • Good citizenship
  • All current Leadership Springfield members
  • Outstanding leadership qualities
  • High moral and ethical standards
Nominee First Name
Nominee Last Name
Class #
Mailing address (preferred)
Business Phone
Mobile Phone
Keeping in mind the criteria listed; please write a
brief paragraph telling us why your nominee is
the best candidate for the 2018 Leadership
Springfield Kenworthy Award.

Your contact information

First Name
Last Name
Business Phone