2023 Citizenship Award Form

For its prestigious Citizenship Award the Shelter Island Lions Club selects annually an individual or individuals who have demonstrated outstanding voluntary service to the Shelter Island community.   The award is presented at a dinner in May to which all Islanders are invited and a description of the service performed by the awardee(s) is published in the Shelter Island Reporter.

Note that nominations for the Citizenship Award may be submitted by anyone in the Shelter Island community and there is no requirement that nominees be affiliated with the Lions Club.

Application guidelines and a nomination form for the 2023 Citizenship Award may be downloaded by clicking on the following button.

Printable 2023 Citizenship Award Nomination Form

Please include sufficient information about the nominee(s) and his/her/their community activities to enable the Award Committee and members of the Board to assess the merits of the nominee(s) fairly.

The deadline for receipt of nominations for the 2023 Citizenship Award is Friday, February 17, 2023.

Forms may be mailed, emailed, faxed, or handed to a member of the Citizenship Award Committee.

Shelter Island Lions Club
Attn: Citizenship Award Committee
P.O. Box 760
Shelter Island, NY 11964

Email: CitizenshipAward@ShelterIslandLions.org

Fax: (631) 749-1818

Citizenship Award Committee: Frank Adipietro MD, Ken Pysher, Jim Read, Frank Vecchio, and Mary-Faith Westervelt

Phone (if you have questions):  (631) 209-7452