IMAGE AWARD NOMINATION FORM 2008

Community Image Awards are presented to individuals/businesses that have made exceptional contributions to their community at the Annual Dinner Meeting. Nominations for these awards are accepted from the membership-at-large and the Image Award Committee makes selections based on those nominations. Please print and complete this form to nominate the leaders of your choice.

I nominate ________________________________ for the Excellence in Business and/or Service Award. This
individual is an individual business/partnership/corporation or organization that has shown evidence of strong growth,
demonstrated visions for their business or exemplified an attitude of service toward others. The nominee has
demonstrated a willingness and history of going above and beyond the call of duty in their business or acts of service.

Reason for Nomination: ___________________________________________________________________________________

_______________________________________________________________________________________________________

Nominator's Name:___________________________________________

I wish to nominate ___________________________________for the Community Leadership Award. This individual/business/group of individuals has consistently shown leadership in enhancing the image of this
community. The nominee has demonstrated an ability and history of promoting a positive image for the
Gas City/Jonesboro area.

Reason for Nomination: __________________________________________________________________________________

_____________________________________________________________________________________________________

Nominator's Name: ____________________________________________

Thank YOU for taking the time to recognize our community leaders. The prestigious awards will be presented
at the Annual Meeting (Date TBA). If you have any questions, please call the office at 765.674.7545
or e-mail gascity@comteck.com.

Award Sponsors

Salin Bank & Trust Company

Needham-Storey-Wampner Funeral Service

Mutual Federal Savings Bank/Gas City Area Chamber

Mail Nomination To

Gas City Area Chamber of Commerce

316 E. Main Street

Gas City, IN 46933

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