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Form

One hero will be selected each month. Everyday Hero profiles are scheduled to air in Heartland News at 10:00 p.m. on the last Sunday of each month and the following Monday on Heartland News Now at 4 p.m.

*Denotes Required Fields

Name*

First

Last

Your Email*

Your Hometown*

City

State

Zip

Your daytime phone*

Your Hero's Name

Your Hero's Occupation*

Your Hero's Address*

City, State, Zip*

Your Hero's Phone Number*

Why do you think this person is a hero?*

I have read the Privacy Statement and Official Rules*

Enter

Privacy Statement and Official Rules