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Hello and welcome. My office is seeking nominations for the 2021 First Responder of the Year Award. This award highlights the great work the brave men and women of our emergency services are doing in our communities. If you know a firefighter, police officer, or EMS worker from the 39th Assembly District who embodies community service, selflessness, and dedication, please fill out the information below. One deserving individual will be selected and invited down to the State Capitol in October to be honored for their work.

Please provide your first and last name.
Please provide your contact information (phone number and email).
Please provide the first and last name of the person nominated.
Please provide the contact information (phone number and email) for the nominee.
Please provide a description of this person's accomplishments and why you feel they are deserving of this award.