TOTEM AWARD FOR ORGANIZATION OR BUSINESS

KALAMA AWARD NOMINATION

Name of Nominee _________________________________________________

Address ________________________________City______________ State______ Zip ___________

Business Organization

ELIGIBILITY

To be eligible for this award, each nominee must be established in the Kalama area.

QUALIFICATIONS

Please provide complete and concise information regarding the following information:

A. Community Activities

a. Civic mindedness

b. Services to the community

c. Current activities – local, state, national

B. Past Service

a. Participation in programs beneficial to the general public

b. Steadiness of purpose

c. Ability to work with all people

ALL NOMINATION FORMS MUST BE SIGNED BY THE INDIVIDUAL SUBMITTING THE NOMINATION.

_________________________________ _____________________________________

Name of person submitting nomination Signature of person submitting nomination

Address ________________________________City______________ State______ Zip ___________

Phone number (360) _____ - ___________

Please send your nomination to: Kalama Chamber of Commerce

Citizen of the Year Award

PO Box 824

Kalama, WA 98625