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COMMUNITY SERVICE AWARD NOMINATION FORM

Good business isn't always measured in dollars and cents — it extends beyond your own company into the community at large. Help recognize companies leading the way in community consciousness and activism with your nomination. Submissions must be received by February 7, 2013.

* Required fields
SUBMITTED BY
* Your Name:
* Company:
* Phone:
* Email:
NOMINEE INFORMATION
* Name:
* Company:
Address:
City:
State:
ZIP Code:
* Phone:
* Email:
* Significant Community Service Contribution: Briefly describe the program undertaken by this company in which it played a leadership role.
* Goals: Briefly describe the objectives of the program.
* Implementation: Briefly describe the steps taken to implement the program.
* Results: Briefly list the results of this program.