The “Heart of a Samaritan” award was formed in 2004 as a way to honor individuals, families and corporations who give unselfishly of their talents and resources to help others who are in need. We need your help this year in finding our community's "Unknown Samaritan." Please complete this form if you know of a company, person, or family that we could honor.

Company or Name of Person to Be Nominated:
Nominated By:
Fax/Phone:
Email:
Does the nominee have a connection with Samaritan?
Reason why this company/person should receive the “Heart of a Samaritan Award”: