Community Enrichment Award Nomination Application - Burlington County Regional Chamber of Commerce

Community Enrichment Award Nomination Application

Nominee should be a Non-profit organization/agency that makes Burlington County a better place; demonstrates evidence that the nominee has made a positive impact on the lives of Burlington County Residents; nominator must explain what the nominee has done in the community, with specific examples of its good works.

Fields marked with an * are required.

About the Nominee
Please fill out all necessary information regarding the nominee.

Name of Nominee *

Name of individual or company/organization

Email address *

Nominee's email address

Mailing Address *

Nominee's Mailing Address

Phone Number *

Nominee's Phone Number

Website *

Nominee's Website

About the Nominator
Please fill out all necessary information about yourself, the nominator.

Name *

Your Name

Company Name

Your company name

Phone Number *

A good number to reach you at

Email Address *

Your email address

Relationship to Nominee *

How do you know them?

Application
Please complete the application for the nominee to the best of your ability. Click 'Submit' when finished. You will receive a confirmation notice that your application has been submitted. Please note: You can fill out more than 1 application and nominate more than 1 individual/company.

Please describe the mission, vision and goals of the organization. *

What are the programs, projects or services the nominee provides to accomplish its mission? *

Please be specific.

How has the nominee made a positive impact on the lives of Burlington County residents? *

Your turn: Are there any other interesting details you'd like to share? (Optional)

Would you like the nominee to be considered for any other award category?

Business Excellence Award

Economic Development Award

New Voice Award

Outstanding Main Street Business Award

Outstanding Woman Business Executive Award

Outstanding Young Professional Award

Personal Excellence Award

Public Voice Award

Voice of Business Award

Please verify that you have checked the “I'm not a robot” checkbox.