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Outstanding Senior Program

Outstanding Senior Citizen ONLINE Application

We are looking for one female and one male over the age of 65 by January 1^st 2025 to honor as an Outstanding Senior Citizen.

This nomination should be for someone that volunteers within an organization or community and goes above and beyond what is expected from them.

Completed applications need to be received by June 20,2025

Please complete this online form

OR complete a printed PDF Application and scan and email to Tgutknecht@wrightcountyfair.org or mail it to:

Wright County Senior Program C/O Tracy Gutknecht - 6568 30^th ST NE Buffalo, MN 55313

Winners will be recognized during the Senior Program on Senior Citizen Day at the

Wright County Fair in Howard Lake, MN on Friday July 25^th at 1pm

Senior Luncheon is at 11:30 am for $3.00 per person in the Hoop Building

Senior Citizen Program is at 1:00 pm on the Barnyard Stage

Nominee Information

Nominee Name

Nominee Date of Birth

Sex

Male
Female

Address Line 1

Address Line 2

City

State

Postal Code

Phone Number

Nominated By

How long have you known the Nominee

How do you know the Nominee

What does the Nominee do that makes them Outstanding Senior Volunteer? Use specific examples.

Tell us about the Community Organizations or Committees the Nominee belongs to

Include Name of Organization and Responsibilities

Service Awards *Received after age 60

List outstanding accomplishments, awards, or honor

Volunteer Activities

List any and all Volunteer Activities and Benefits to the Community/Organizations

Use as many sections below as needed

Volunteer Activity/Organization

Activity or Responsibility

Benefits to the Community/Organization

Time Commitment

Volunteer Activity

Volunteer Activity/Organization

Activity or Responsibility

Benefits to the Community/Organization

Time Commitment

Volunteer Activity

Volunteer Activity/Organization

Activity or Responsibility

Benefits to the Community/Organization

Time Commitment

If your Nominee is active in more activities or organizations, please fill out another form with additional information for these fields or attach a file at the end of this form with all necessary information.

Information of the person filling out this form

First Name

Last Name

Email Address

Sign me up for email updates

Address Line 1

Address Line 2

City

State

Postal Code

Phone Number

Letters of Recommendation for the Nominee **Or attach any additional information

Anything else not addressed in this form that you'd like us to consider in relation to the Nominee?

optional

We welcome up to 3 letters of recommendation for the nominee.

Thank you for your time in filling out this application.

Feel free to discuss your nomination with your Nominee and collect all information needed on their volunteer activity.

Questions? Please contact:

Amy: Amatter@wrightcountyfair.org or 612-770-8144

Tracy: Tgutknecht@wrightcountyfair.org or 612-919-1392

Trista: Tconzet@wrightcountyfair.org or 612-221-5248

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