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Community Leadership Award Nomination Form
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Nominee Information
Since 1991, the Community Leadership Award has been given annually to the business leader or organization who has most positively impacted the community through their excellence in business leadership and community service over their lifetime. The major criteria to be considered for the award include:
1. Giving freely and unselfishly of their time to community activities.
2. Inspiring others and acting as a role model.
3. Having a positive impact on the direction and success of an economic development project or community program.
4. Improving the lives of others.
5. Going over and above the expectation of their position or mission in providing community service.
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(Required)
Resume or list most outstanding achievements with a focus on one of the criteria that the award embodies.
(Required)
Nomination Submitted By
Name
First
Last
Address
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Daytime Phone
Evening Phone
Email
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