MGM IMPACT MAKERS NOMINATION FORM

NOMINEE - INDIVIDUAL OR COMPANY NAME: *

Please enter the individual or company name you want to nominate. Self nominations are accepted.

SUBMITTED BY? *

Please include your name, company name and contact information.

CATEGORIES FOR NOMINEES: *

Individual (YP, Entrepreneur, Executive) Non-Profit Small Business (under 10 employees) Mid-Size Business (10 to 50 employees) Large Business/Corporation (50+ employees)

AREA OF IMPACT: *

Talent Economy Image Community Military

Please choose the greatest area of impact.

WHY ARE YOU NOMINATING THIS INDIVIDUAL OR BUSINESS? HOW ARE THEY MAKING AN IMPACT? *

ANY ADDITIONAL INFORMATION, EXAMPLES OF SERVICE OR IMPACT?

Please include any additional information on why you think this individual or company deserves this award.

MAY WE CONTACT YOU FOR ADDITIONAL INFORMATION REGARDING YOUR NOMINATION? *

YES NO

EXPOSURE FOR THE NOMINEES - • Featured on the Chamber’s website (link and logo) • Featured in weekly enewsletters (link and logo) • Featured on the Chamber’s FB Page (small company bio) • Nominees will be featured in the Montgomery Advertiser MGM Impact Makers Ad, during the voting period • Published listing of the Finalist in the September MBJ • Recipients will be featured in the MBJ and the Montgomery Advertiser Award Ad in November

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