Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

City of Rock Island Citizen of the Year Online Nomination Form

  1. Deadline for Nominations is Friday, June 8, 2018.

  2. Category: (Check One)

  3. If you have any questions, call Dylan Parker at 309-738-3416, Dave Geenen at 309-738-4569 or Judith Gilbert at 309-732-2010.

  4. Leave This Blank:

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