Nomination Form

Award Category:

Nominee Information

Nominee Name:
 
Contact Name:
(if Nominee is a company)
 
Contact Title:
Nominee Address:
 
City:
 
State:
 
Zip Code:
 
Nominee Phone:
 
Nominee E-mail:
 
Website Url:

Nominator Information

Nominator Name:
 
Name of CEO:

(If nominator is a business, please complete this field.)
Nominator Title:
Nominator Phone:
 
Nominator E-mail:
 
Nominator Address:
 
City:
 
State:
 
Zip Code:
 
Primary Contact Name:
(if different from Nominator)
 
Primary Contact Phone:
(if different from Nominator)
 
Primary Contact E-mail:
(if different from Nominator)
 

Your Nominee must meet the following criteria: All are required.

Nominee resides in or impacts an agency in Lake, Orange, Osceola, Seminole or Volusia County

Nominated organization is a 501(c)(3) nonprofit organization registered in the five county area (applicable to AFP non-profit organization nominees)

Nominee has not previously received an award in the same category within past five years (please see History of Award Winners.)

Nominee’s permission has been obtained and nominee agrees to be present at National Philanthropy Day

Your nomination must include:

Please select an Award Category (above) to view nomination instructions.

Uploadable document file extensions are limited to: pdf, doc, docx, rtf

Click on the field to add a narrative document. Required!

Click on a field to add a maximum of three reference letters (optional)

One page cover letter (optional):

Nomination submitted electronically by Friday, June 21, 2019

Type your name below. This is your electronic signature.

 

By clicking the Submit Form button below, you are agreeing
that all information provided is accurate and complete.