Date

NOMINEE INFORMATION

Name

Position/Title

Affiliated With

Street Address

City
State

Zip

Business Phone

Home Phone

Category of Nomination (check one)

The Cleveland Arts Prize

Architecture
Dance
Literature
Music
Visual Arts

Special Citation for Distinguished Service to the Arts
The Robert P. Bergman Prize

NOMINATOR INFORMATION

Name

Position/Title

Affiliated With

Street Address

City
State

Zip

Business phone

Home phone

Fax

E-mail

RATIONALE FOR NOMINATION
(You may wish to cut and paste your responses below.)

(For Arts Prize nominations only)
What local and national recognition has this work received?

(For Special Citation and The Robert P. Bergman Prize nominations only)
How has this work benefited Greater Cleveland and specifically whom has it benefited?

In what capacity and for how long have you known
and/or worked with the nominee?

Please click Submit to review your nomination.