Please nominate a first responder in our community so we can recognize them in the Wisconsin Legislature.

2025 First Responder of the Year Nomination Form

First Responder of the Year Nomination

Name of First Responder Nominated *

Nominee's Position/Job Title *

I nominate this person for First Responder of the Year because...

Your Information

Name of person/group making the nomination *

Email *

I would like to be added to the Heart of Wisconsin Newsletter

Download a fillable PDF for your nomination below and email or mail it to my office.

First Responder Nomination Form PDF