Form Center

2. When times are tough, heroes emerge. We all know someone who is making a difference right now as we live through these unique times. The Klamath County Board of Commissioners is proud to launch the Klamath County Everyday Hero Program. The Program is a recognition program for Klamath County citizens who make a difference, big and small, in other people’s lives and in our community.
   To nominate a person to be recognized by the Board of County Commissioners as a Klamath County Everyday Hero, fill in the boxes below, and click the submit button. If chosen, Everyday Heroes will receive a recognition pin and letter from the Board of County Commissioners and their story will be featured on our social media pages.
6. Nominee's First Name
7. Nominee's Last Name
9. Nominee's Address
11. City
12. State
13. Zip Code
15. Nominee's Phone Number
16. Nominee's Email Address
18. What does the nominee do for work?
20. Your First Name
21. Your Last Name
23. Your Phone Number
24. Your Email Address
26. Why do you think your nominee should be recognized as an Everyday Hero?
28. What is one thing you want everyone to know about your Everyday Hero?
30. Upload a photo of your Everyday Hero nominee
    *This photo may be posted on our social media pages.
32. Optional:

    Check here if

    1. You wish to remain anonymous to your nominee.
34. Disclaimer
    By signing below, I authorize Klamath County, to create, receive, or use my photos, photos of me, my voice, recordings of my voice, my quotes, or phrases said by me, for use in the publication of the Everyday Hero Recognition Program. I hereby relinquish all rights, title, and interests I have in the use of my likeness in the above noted program. I further hereby release Klamath County from any liability related to the publication or distribution of my likeness as described above in relation to the Everyday Hero Recognition Program.
36. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
38. Electronic Signature
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit Submit and Print

* indicates a required field