Impact Award Nomination Form

Business *

Phone Number *

Address *

Representative *

Position *

Email *

1.) How has this business contributed to the welfare and betterment of the community? *

2.) Provide evidence of lasting contribution to the community and the impact that has resulted. *

3.) How has this business participated in community activities and civic enterprises? *

4.) Provide evidence of staff sustainability and business progress. *

5.) How has this business cooperated with individuals and civic organizations? *

Name *

Phone Number *

Email *

Address *

Business *

Position *

Are you a Chamber Partner? *