Nassau County, NY

Nassau County Office of Hispanic Affairs
Dominican Republic Independence Day Celebration Honoree Nomination Form

The nomination period has closed. Last day of nominations was February 18, 2021. Thank you.

Nassau County will host its Annual Dominican Republic Independence Day Celebration virtually on Friday, February 26th, 2021 at 5:30pm

The public is invited to nominate Dominican-American residents who have contributed and made a difference in Nassau County. Please fill out all required fields and review the form before submitting. The Nassau County Office of Hispanic Affairs’ Cultural Planning Committee will use this form to evaluate the nominees and choose from all submissions. The selected honorees will be recognized at our Dominican Independence Day Virtual Celebration.

All are invited to join us in this virtual event to honor the contributions and accomplishments of Dominican-Americans in Nassau County. Please email us at NCHispanicAffairs@nassaucountyny.gov to receive notifications of the event

All nominations must be completed and submitted by Thursday, February 18th, 2021.

Thank you for taking the time to complete the Dominican Republic Independence Day Honoree Nomination Form.

All fields marked with a red asterisk (*) are required.

STEP 1 Nominee Information

Nominee must be a Nassau County Resident

Name: *

Address 1: *

Address 2:

City: *

State: *

Zip Code: *

Phone Number: *

Email Address:

Employer:

STEP 2 Your Information

Name: *

Address 1: *

Address 2:

City: *

State: *

Zip Code: *

Phone Number: *

Email Address: *

STEP 3 Nominee Contributions

In your own words, please describe how your nominee has improved the well-being of the community:

STEP 4 Award Title

Please select the title of the award you would like your nominee to be considered for: