Nominate for 2017 ( Attention: Last day of submission is Sunday, April 23, 2017 )
  1. Your Name(*)
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  2. Address
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  3. Email address(*)
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  4. City
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  5. State/Province
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  6. E-mail address
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  7. Phone number
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  8. Please describe your nominee's specific communal category. (*)
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  9. In your own words, why does your nominee deserve recognition as a Citizen of Burma Award? Please describe in detail your nominee's specific accomplishment and what was involved in achieving it. (200 word maximum) (*)
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  10. If you would like to share any websites, articles or books about your nominee's activities.
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