ANEXO I
FICHA DE INSCRIÇÃO - PRÊMIO “ZUMBI DOS PALMARES” - EDIÇÃO 2023
1. Categoria Cultural
- Indicação: _______________________________________________________
- Breve Justificativa da Indicação:______________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _________________________________________________________________
2. Categoria Esporte
- Indicação: _______________________________________________________
- Breve Justificativa da Indicação:______________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _________________________________________________________________
3. Categoria Saúde
- Indicação: _______________________________________________________
- Breve Justificativa da Indicação:______________________________________ ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4. Categoria Educação
- Indicação: _______________________________________________________
- Breve Justificativa da Indicação:______________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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5. Categoria Cidadania
- Indicação: _______________________________________________________
- Breve Justificativa da Indicação:______________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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6. Categoria Personalidade 2022
- Indicação: _______________________________________________________
- Breve Justificativa da Indicação:______________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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