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AUGUSTA
AWARD NOMINATION FORM
The
Augusta Award is a prestigious civic honor created
in the year 2000 to recognize individuals of exemplary
character who have made a significant contribution
to the progress, harmony or quality of life within
the community. The award is jointly sponsored by
the Augusta Metro Chamber of Commerce and the Central
Savannah River Area Community Foundation, Inc. The
honor is bestowed based upon the following criteria:
- The
recipient shall be a current or former resident
of Metropolitan Augusta.
- The
recipient shall have demonstrated strong evidence
of personal, business or professional achievement.
- The
recipient shall have demonstrated strong evidence
of community involvement, commitment, leadership
and service.
- The
recipient’s contribution to the community must
be measurable in terms of economic or social
progress; improved unity, tolerance or collaboration
among the citizens; or overall improvement in
the quality of life for a significant population,
as determined by the panel of judges.
2001
Deadline for Nominations
Nominations
received for last year’s award consideration are
automatically eligible for current year, e.g. all
non-winning candidates in 2000. All new nominees
must be received no later than 10/31/01.
Please
mail all new nominations to:
THE
AUGUST METRO CHAMBER OF COMMERCE
ATTN:
THE AUGUSTA AWARD
P.O.
BOX 1837, 600 BROAD STREET PLAZA
AUGUSTA,
GA 30903-1837
OR
FAX TO: (706) 821-1330
Click
here for printer friendly version of form.
NOMINATION
FORM
The
Augusta Award
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NOMINEE
INFORMATION
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NAME
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ADDRESS:
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PLACE
OF BIRTH:
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AGE:
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SPOUSE:
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CHILDREN:
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BUSINESS
AND PROFESSION
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OCCUPATION,
PROFESSION OR CAREER:
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DESCRIPTION
OF RESPONSIBILITIES:
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OR PROFESSIONAL ACCOMPLISHMENTS (AWARDS, ORGANIZATIONS,
ETC.): |
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OTHER
RELEVANT BUSINESS OR PROFESSIONAL INFORMATION:
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COMMUNITY
ACTIVITIES
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LIST
OF ORGANIZATION MEMBERSHIPS:
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OF BOARD AFFILITIATIONS: |
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LIST
OF NOMINEE’S ACTIVITIES AND ACCOMPLISHMENTS:
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RELIGIOUS
ACTIVITIES (OPTIONAL) |
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RELIGIOUS
AFFILIATION:
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NAME
OF CHURCH:
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DESCRIBE
RELIGIOUS ACTIVITIES AND ACCOMPLISHMENTS:
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SUMMARY:
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BRIEFLY
DESCRIBE HOW YOUR NOMINEE HAS DISTINGUISHED
HIM OR
HERSELF AS A CITIZEN OF AUGUSTA IN SERVICE
AND CONTRIBUTION TO THE TOTAL COMMUNITY.
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IF
POSSIBLE, PLEASE ENSURE THAT THE ABOVE-NAMED
NOMINEE IS AWARE OF THIS NOMINATION.
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DATED:
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SIGNATURE
OF NOMINATOR:
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TYPED/PRINTED
NAME OF NOMINATOR:
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BUSINESS
ADDRESS:
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HOME
ADDRESS:
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BUSINESS
TELEPHONE:
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HOME
TELEPHONE:
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