Landlover Nomination Form

Full name (Mr./Mrs./Ms)

Street Address

City/State/Zip

Phone(H)

Phone(W)

District:

The nominated property most meet the following criteria:

	The resident does not employ a professional care service on a regular basis.
	The property is litter free
	The owner must participate in some sort of ongoing recycling program(curbside, drop-off, composting, etc.)
	The owner gives permission to participate in the program
	The property has not previously won this award
	The property is within Henrico County limits
	I will email picture of the property

I confirmed the nominated property meets all of the above criteria

Comments limited to this space only:

Full name (Mr./Mrs./Ms

Street Address

City/State/Zip

Phone(H)

Phone(W)