Gala - Ben TeKamp Memorial Award Nominee

First Name *

Last Name

Email *

Phone *

Nominee Name *

Nominee Business/Organization

Location of Business/Organization

Years in business

Is the Nominee aware of this nomination?

Yes

No

Is the nominee a member of the Brockville & District Chamber of Commerce?

Yes

No

Nominee Email

Nominee Phone *

Describe the nominee's business acumen: *

Illustrate how the nominee's vision is aligned with Ben TeKamp's described vision: *

Give examples of the nominee’ perseverance, collaborative nature and leadership: *

Describe the nominee’s business growth and sustainable practices: *

How does the nominee positively impact and contribute to the Brockville and district communities?

Any Additional Information