Champion or Keys of Character Award Nomination Form Address 2209 SW 29th St, Topeka, KS 66611 Contact (785) 266-8666 Please nominate a Topeka or Shawnee County citizen to be considered for a character recognition certificate. Good character is the inward motivation to do what is right whatever the cost. Think of how the character quality recognized significantly improves the health, safety or quality of life of the community. See the back of this form for the 49 character qualities recognized by the Topeka City of Character.Nominee InformationName of Nominee* First Last Nominee Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Nominee Phone*Character Quality Exhibited*(From the list of 49 qualities)Please explain why you think this individual should receive an award for exhibiting good character that has significantly improved the health, safety, or the quality of life of the community.*Selection of candidate for award will be made by a Character Review Committee on behalf of the Character Recognition Council. This program is a joint effort of the Safe Streets Coalition of Topeka and Shawnee County and Topeka City of Character.Submitted BySubmitter Name* First Last Submitter Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Submitter Phone*Submitter Email* CAPTCHA