Nomination Form – Greater Arnprior Chamber of Commerce

Online Nomination Form

Name:*

First

Last

Address:

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code Country

Your Daytime Telephone*

Area Code

Phone Number

Your E-mail:

Choose a Category

Young Entrepreneur / Young Community Involvement Under 30

Innovation Award for Visual Creativity

Business / Business Person of the Year Award

Skilled Trade Business

New Business Venture Award

Business or Individual Nominee Description

Describe the business or individual that you have nominated for an award. If there is any supporting documentation (e.g. copies of awards, certificates, newspaper clippings, press release) it can be dropped off to the Chamber of Commerce office.

Business/Individual Name

Business Address

Street Address Street Address Line 2 City Province Postal Code

Contact Name

First

Last

Contact Title

Business Telephone

Area Code

Phone Number

Years in Business

Number of Employees

General Description of Business Activities:

Your reason for nominating this individual or company:

Before submitting your nomination, please read the award descriptions and rules to ensure your nominee fits the parameters of the award program. Personal information on this form will be used to determine eligibility and notify recipients of the nomination. By submitting this nomination you are certifying that to the best of your knowledge all of the information provided on this form is true and you believe that this nominee is deserving of a Greater Arnprior Chamber of Commerce Award.