Eli Rudin Second Half Hero Award Nomination

In 2010, Lifespan would like to honor people age 100 (or older!). Fill in the form below and click at the bottom to submit your nomination for Lifespan's Eli Rudin Second Half Hero Awards.

I am nominating the following person for
Lifespan's Eli Rudin Second Half Hero Award.

nominee*
nominee's address*
city*
state*
 zip code*
nominee's phone*

.Does the nominee know that you are submitting?

.
my name*
my phone*
my address*
city*
state* zip code*
my email*
.
.

Tell us about your nominee.

 

Why do you personally consider this person a role model for longer life?

 
Anything else you’d like to add about your nominee's attitude about life.

Thank you!

The Eli Rudin Second Half Hero Awards are underwritten by MedAmerica Insurance Co. of New York, an Excellus Company.

The submission deadline is Friday, February 5, 2010.

You may submit other materials in addition to the form by mailing to Lifespan, 1900 S Clinton Avenue, Rochester, NY 14618. On-line submission of the nomination form or a typed form is preferable to a handwritten form.