Awards Nomination Form 2011 Lifetime Achievement

Home

2011 Leadership Charlotte Legacy Awards

Lifetime Achievement Award

This individual has demonstrated a commitment over time to serving the community in various capacities. He/She has made significant contributions, both personally and professionally, to the betterment of Charlotte and serves as a role model in volunteer community leadership.

Please submit one (1) nomination per form.

Nominator Name:

Nominator Phone:

Nominator Email:

Are you a Leadership Charlotte Graduate?

Yes

If yes, what class?

NOMINEE NAME:

Nominee Business:

Nominee Address:

Nominee Phone:

Nominee Email:

Is the nominee a Leadership Charlotte graduate? (not a requirement for this award):

Yes

If yes, what class?

Explain how this individual has demonstrated his/her commitment over time to serving the Charlotte-Mecklenburg community:

Personal contributions to the betterment of Charlotte-Mecklenburg:

Professional contributions to the betterment of Charlotte-Mecklenburg:

Examples of how this individual has served as a role model in volunteer community leadership:

Other notable professional accomplishments:

Other notable civic contributions:

Board Participation:

Affiliations:

Notable awards recognition:

Other information you would like to share about the nominee:

Contact Name:

Contact Phone:

Contact Email:

To help us avoid computer generated inquiries and spam, please enter the letters and numbers exactly as you see them in the box below.

Reload Image

© 2010 Leadership Charlotte. All Rights Reserved.
No portion of LeadershipCharlotte.org may be duplicated, redistributed or manipulated in any form
without the expressed written consent of Leadership Charlotte.