Annie Vamper Helping Hands Award Nomination Form

Nomination Deadline: September 1, 2016

Name of the person you wish to nominate*

First Last

Name of their credit union

Nominee Day/Work Phone*

Nominee Evening/Weekend Phone

Nominee Email

Your Email*

Nomination Questionnaire

This questionnaire should be completed by the person/credit union who is nominating an individual for an award.

How long has the nominee been involved in the credit union movement?*

Which credit union(s) has the nominee assisted, volunteered in or worked for?*

Please describe how the nominee has helped the credit union(s) in which he or she served. What has he/she done, when, for how long, and what were the effects?*

In your own words, please explain what makes this nominee especially deserving of this award?*

If the nominee is selected, will your credit union or organization be able to assist him/her with their expenses (if necessary) to travel to Dallas, TX on Tuesday, November 15, 2016?*

Yes
No

Please forward news clippings, articles, testimonials, etc., to help our committee make an informed decision. Please contact Pamela Owens at powens@inclusiv.org or (212) 809-1850 x 215 with any questions.

Annie Vamper Award Nomination Form

Nomination Deadline: September 1, 2016

Nomination Questionnaire

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