Chamber Alliance of Lake County

2020 Lake County Community Service Awards Nomination Form
Sponsors

COMPLETED FORMS: by March 2, 2020

Online or E-MAIL: mandywettstein+2020CSA@gmail.com or

POST: Lake County Community Service Awards, Lake County Chamber Alliance , Attn: 2020 CSA, PO Box 709, Mount Dora 32756

PURPOSE: To annually recognize and publicly honor outstanding community service in the categories below, at an Awards Banquet on May 06, 2020.

INSTRUCTIONS:
Review the list of previous award winners as recipients can only win once in a category.
Review the description of the awards and select ONLY ONE category per nomination.
In completing the application, please type and use an easy to read font, and no less than 12 pt. ONE additional page, no more than 500 words, is required to give the reasons for nomination, to help differentiate the nominee and to outline community involvement

CATEGORIES:

Arts/Cultural
Leadership
Humanitarian
Volunteer
Health Care Provider
Hall of Fame Business
Public Service
Chris Daniels Public Safety
Non-Profit Organization
Education
Sports/Athletics
Entrepreneur
Youth Award
Business Achievement
Small (1-11 employees)
Medium (12-39 employees)
Large (40+ employees)

 

NOMINEE:

Name

Business/Profession/Association

Address

Phones

E-mail

AWARDS RECEIVED BY NOMINEE THAT RELATE TO CATEGORY

1.

2.

3.

4.

CLUBS,ORGANIZATIONS, AND POSITIONS THAT RELATE TO THE CATEGORY

1.

2.

3.

NOMINATOR

Name

Address

Phones

E-mail

Reasons For Nomination (Required to give the reasons for nomination, to help differentiate the nominee and to outline community involvement.)

characters left

 

 

 

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