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2021 Citizen, Young Citizen, and Organization of the Year Nomination Form

  1. Each year, the City of Dublin recognizes a Citizen and Young Citizen who have made a significant contribution toward enhancing the quality of life for residents of Dublin during the previous calendar year (2021). Additionally, a non-profit organization that has provided services, which have substantially benefitted the residents of Dublin, is also recognized. A celebratory event announcing the Citizen, Young Citizen, and Organization of the Year winners will be held in March 2022 (date TBA) at Shannon Community Center. The Citizen and Young Citizen of the Year will each receive a $300 donation made payable to the non-profit organization of their choice; and the Organization of the Year will receive a $500 cash prize.

  2. I am nominating for...*
  3. Was the nominee a Dublin resident in 2021? (Required for Citizen and Young Citizen only):
  4. In order to be considered, nominations must be submitted electronically or in person to the City Manager's Office, 100 Civic Plaza, Dublin, CA 94568, Attn: Shari Jackman, no later than 5:00 PM on Friday, January 21, 2022. Postmarks will not be accepted.

  5. If you select "Submit," your application will be sent electronically to the City Manager's office. If you'd like to retain a copy of your application, please choose "Submit and Print." After you click this button, you will be shown a page with your information provided. Please choose Print from your "File" navigation and then select "Continue."
  6. Leave This Blank:

  7. This field is not part of the form submission.