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Commemorative Program - Honorary Streets Application Form

  1. VILLAGE OF ROMEOVILLE COMMEMORATIVE PROGRAM


    Honorary Streets Application Form

  2. The Village of Romeoville is offering a unique opportunity for residents to honor a current or former community member through the Commemoration Program. The program is utilized as a way to recognize individuals that have made a significant contribution or impact on the community.

  3. APPLICATION PROCESS

    The nominator should complete the appropriate form, providing detailed information about the major accomplishments in which you believe qualifies your honoree for this commemoration. Nominators should list accomplishments and services provided to the community outside the honoree’s job or scope of work. Please check area of contribution and complete the nomination statements. If the honoree’s achievement is through a specific organization, please elaborate on the scope of service and any offices held, including dates with the organization. Information on personal, educational and business background is helpful. The nominator must complete and submit the form.

    The Committee will then make a recommendation to the Village Board. If approved, a proclamation will be passed and presented to the family of the individual. Each application must meet the criteria as set forth, although meeting all criteria does not ensure naming rights. The Committee has the right to deny any application for any reason at any time or waive requirements as set forth. Applications with names or nick names that endorse or advocate religion or specific religious beliefs, have obscene connotations, or demean or attempt to intimidate any group based on the group’s race, ethnicity, age, gender, disability, or sexual orientation will be denied.

  4. QUALIFICATIONS

    To qualify, the honoree must be deceased and had been a Romeoville resident for over 20 years, or volunteered in Romeoville for more than 20 years, as well as had made a significant contribution or impact on the community. The Village has the right to conduct a background check to confirm the information provided.

  5. SELECTION

    The completed form will be reviewed to determine if all criteria has been met. If all criteria has been met, the nominee’s application will be forwarded to the Commemorative Program Committee which consists of an elected official, the Village Manager, a Village of Romeoville employee, a Non-profit representative and a Romeoville resident.

    For Honorary Streets and Permanent Buildings, Parks and Pavilions, the Committee will review the honoree nomination based on the following categories and score accordingly: Impact to Community (up to 3 pts.) Financial Contribution (up to 3 pts.) Active Organization Participation (up to 4 pts.) Based on total points received, the Committee will determine if the honoree will receive commemoration.

  6. NOTIFICATION

    If honoree is selected, the Committee will inform the nominator and the honoree via letter. The honoree will be honored at a Village Board meeting.

  7. NOMINATOR INFORMATION

  8. HONOREE INFORMATION

  9. QUALIFICATIONS

  10. Is the honoree deceased?

  11. Was the honoree a Romeoville resident for over 20 years?

  12. Did the honoree volunteer in Romeoville for more than 20 years?

  13. Define Area of Contribution: Please check appropriate area (s) of community service:

  14. NOMINATION STATEMENTS

  15. STREET SIGN PERSONALIZATION

  16. CONDITIONS

  17. Checking the box indicates that I certify that all statements and information furnished in this form are true, complete and correct to the best of my knowledge, and are made in good faith. I understand that statements or information furnished on this form are subject to verification and I agree to furnish supporting documents or information when requested.

  18. NOMINATION REVIEW - FOR OFFICE USE ONLY

  19. Does honoree meet residency requirements of over 20 years?

  20. Does honoree meet volunteer requirements of over 20 years?

  21. Please score all fields accordingly.

  22. Impact to Community (Up to 3 pts.)

  23. Active Organization Participation (Up to 4 pts.)

    Please list each organization that the honoree was an active participant of. One point will be given for each organization for a maximum of 4 pts.

  24. Major Financial Contribution (3 pts.)

  25. OFFICE USE ONLY

  26. The completed form will be submitted via email for review and approval. For additional information, contact the Village of Romeoville at 815-886-7200.

  27. Leave This Blank:

  28. This field is not part of the form submission.