2. 
4. Human Relations Committee
   Humanitarian Award Nomination Form
6. The Bismarck Human Relations Committee is seeking an individual, business or non-profit organization that has exhibited leadership in the area of human rights. We want to recognize people that educate, identify, protect and promote personal dignity with a focus on eliminating discriminatory barriers that would prevent people from reaching their full human potential.
8. Nomination Type*
   -- Select One --Individual NominationBusiness / Nonprofit Organization Nomination

   Please select the type of nomination you are submitting.
10. Name of Nominee / Name of Organization:*
12. Occupation (Individual Nomination Only):
14. CEO/Executive Director (Business/Nonprofit Nomination Only):
16. Nominee Address:
18. City
19. State
20. Zip
22. Nominee Phone Number:*
23. Nominee Email Address:
25. Please tell us about your chosen nominee.*
    Please tell us about your chosen nominee. Specifically, how the nominee demonstrates leadership and helps to educate others in the areas of human rights. Please attach a separate document if you require additional space other than what is provided.
27. Additional documentation:
31. Name of Individual Making the Nomination:*
32. Phone Number:*
34. Email Address:*
38. Printed Nominations Can Also Be Mailed To:
40. City of Bismarck
42. Administration Department
44. 221 N. 5th Street
46. Bismarck, ND 58501
Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit

* indicates a required field