2011 TRI-CITIAN OF THE YEAR AWARD

NOMINATION FORM

 

(The basic criteria for selection:  The Tri-Citian of the Year demonstrates a high standard of varied volunteer service which demonstrates outstanding leadership and contributes to positive community development and economic impact, causes broad positive impact to people, and improved quality of life in the Tri-Cities.  The foundation of this nomination should be for public or volunteer service, for which no monetary compensation is received.)

 

IMPORTANT NOTE: The Nomination and Selection Committees will base their decisions upon the facts presented on the pages of this form – they will not, themselves, “look up” the nominee’s history for information that might qualify him or her for candidacy.  Therefore, be as thorough as possible – including all available data which will support this nomination.  ATTACHED TESTIMONIALS AND SUPPORTING LETTERS ARE NOT NECESSARY AND WILL NOT BE CONSIDERED FOR THE SELECTION, THEY WILL BE USED FOR THEIR RECIPIENT’S INTRODUCTION AND GIVEN TO THE RECIPIENT.  Nominations should be limited to the Four Pages of this form.

 

(Please print or type)

Name of Candidate:___________________________________________________________________

 

Home Address: ______________________________________________________________________

 

Telephone: (home) __________________________ (office) ___________________________________

 

Occupation or Position: ________________________________________________________________

 

Name and Address of Firm or

Institution Where Employed: ____________________________________________________________

 

___________________________________________________________________________________

 

Prior Tri-Cities Occupation(s), if pertinent:

(Include approximate dates) ____________________________________________________________

 

__________________________________________________________________________________

 

__________________________________________________________________________________

 

 

Number of Years Residence in Greater Tri-Cities: ___________________________________________

 

This Nomination Submitted By: _________________________________________________________

 

Address: ___________________________________________________________________________

 

Telephone: (home) ___________________________ (office) __________________________________

 

Date Submitted: ______________________________________________________________________

 

Send completed form by Friday, February 18th at 5 pm by email to.  If mailing, please have completed form postmarked by Friday, February 18th and mail to: 

 

Email is preferred – send to                                                     or by Mail

sondra@televar.com                                                 Sondra Wilson      Travel Leaders
612 The Parkway  Richland, WA 99352

In the space below, describe the specific deeds, actions, accomplishments, etc., which you feel make this candidate deserving of the Tri-Citian of the Year Award:

Other recognition, honors or awards received, if any:

(When? From whom? For what?)

 

 

Indicate organizations or activities in the Tri-Cities in which this candidate is, or has been, involved:

(For example, consider such areas as Business or Professional; Labor; Educational; Charitable; Service Club; Religious; Youth; Senior Citizens.)

 

                                                            Leadership Role or                                          Approximate

Organization or Activity                      Office(s) Held, if any                                      Dates Active

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other recognition, honors or awards received, if any:

(When? From whom? For what?)

(OPTIONAL): Any additional information which you believe might be helpful to the Selection Committee: