Gala - Community Excellence 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 contributions to the quality of life in Brockville and district communities. *

Including organizational leadership, number of years in business, and strategic approaches.

Give examples of the nominee’s volunteer work and financial contributions to our community. *

Illustrate how the nominee develops community partnerships. *

Include how they support the not-for-profit/charitable sector in our community.

Illustrate how the nominee embraces a commitment to quality. *

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

Any Additional Information