Please enter your preferred name.
Please enter the best email address where we can reach you.
If you would prefer that we contact you by phone, please enter the best number where we can reach you.
Please provide as much contact information as possible for your nomination. Email and phone are preferred.
Maximum size 10MB - For larger files, please email Heroes@GLAPN.org for submission instructions.
You may nominate up to 4 more heroes in this box. Please include their name, contact information, and a brief synopsis of why your nominee deserves this recognition, then use the additional file upload tabs below for photos.