Award Nomination Forms F.M. Torrence Award Nomination FormIt is NOT required to answer every question but the more detailed information you submit the better the chances for your nominee to win. The selection committee will only consider submitted information with the nomination form; please provide as much information as possible for your candidate.Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 3Nominee DetailsName *FirstLastAgeSpouse's NameName & Ages of ChildrenMilitary DutyAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEducation & DegreeVocationNextHow has the nominee contributed in the area of Community Service? *List Nominee's specific accomplishments. *Describe how nominee has encouraged and motivated others in the community. *In 300 words or less, please state comments that support this candidate for the Torrence Award.NextYour DetailsName *FirstLastPhoneAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSubmit Dodds Monument - Industrial Award Nomination FormIt is NOT required to answer every question but the more detailed information you submit the better the chances for your nominee to win. The selection committee will only consider submitted information with the nomination form; please provide as much information as possible for your candidate.Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 3Nominee DetailsName *FirstLastCompany's ContactPhoneAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeNextExplain how the candidate has demonstrated innovation in product and/or process: *Illustrate how the company has been recognized as an industry leader through association affiliations, recognition and applicable awards: *Describe how the candidate has displayed honorable and ethical operation of the business and demonstrated pride in ownership: *Explain how the company demonstrated participation and leadership in the Xenia community: *Please add other relevant comments that support the nomination of your company for the Dodds Monument Industrial Award (attach supporting evidence and/or other pages if necessary): *NextYour DetailsName *FirstLastPhoneAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSubmit Russ Remick Retail - Service Industries Award Nomination FormIt is NOT required to answer every question but the more detailed information you submit the better the chances for your nominee to win. The selection committee will only consider submitted information with the nomination form; please provide as much information as possible for your candidate.Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 3Nominee DetailsName *FirstLastCompany's ContactPhoneAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeNextExplain how the company has demonstrated innovation in product or service presentation and/or delivery: *Illustrate how the candidate has been recognized as an industry leader in their field through association affiliations, recognition and applicable awards: *Describe how the company has displayed honorable and ethical operation of business and demonstrated pride in ownership: *Explain how the company has demonstrated participation and leadership in the Xenia community: *Please add other relevant comments that support this candidate for the Russ Remick RetailService Award (include supporting information and add other pages, if necessary): *NextYour DetailsName *FirstLastPhoneAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSubmit S.L. Stephan Award Nomination FormIt is NOT required to answer every question but the more detailed information you submit the better the chances for your nominee to win. The selection committee will only consider submitted information with the nomination form; please provide as much information as possible for your candidate.Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 3Nominee DetailsName *FirstLastPhoneNumber of Years as a Xenia Area Chamber Member:AddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeNextOver the past two years, describe the activities and involvement of the nominee in the Xenia Area Chamber of Commerce’s activities. *Over the past two years, describe the activities and involvement of the candidate in the Xenia Community. *Beyond serving the Chamber of Commerce and Xenia Community, provide other examples of how this candidate contributes unselfishly and goes above and beyond the sense of duty and expectation. *NextYour DetailsName *FirstLastPhoneAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSubmit Barb Zajbel Xenia Ambassador Award Nomination FormIt is NOT required to answer every question but the more detailed information you submit the better the chances for your nominee to win. The selection committee will only consider submitted information with the nomination form; please provide as much information as possible for your candidate.Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 3Nominee DetailsName *FirstLastIndividual/Company Contact:PhoneAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeNextThe contributions and impact of the nominee in regards to the promotion of Xenia: *Describe how this nominee has positively promoted the city of Xenia regionally: *Explain how this candidate has promoted the city of Xenia nationally: *Provide examples of how this candidate has promoted the city of Xenia internationally: *Explain how the city of Xenia has been directly benefited from the efforts of this nominee and provide examples of such efforts: *NextYour DetailsName *FirstLastPhoneAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSubmit Sheriff Gene Fischer HERO Award Nomination FormIt is NOT required to answer every question but the more detailed information you submit the better the chances for your nominee to win. The selection committee will only consider submitted information with the nomination form; please provide as much information as possible for your candidate.Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 3Nominee DetailsName *FirstLastIndividual's First Responder TitleAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeNextDescribe how candidate has encouraged and exemplified the virtue of good citizenship and/or devoted themselves to sustained and selfless voluntary service: *Describe how candidate has touched and enriched the lives of others, particularly those who are less vulnerable or less able to help themselves: *Describe how candidate has become a role model and earned the respect of their peers in their field: *Describe how the candidate has shown ongoing initiative, leadership, and dedication: *Describe how the candidate had demonstrated innovation and creativity in delivering lasting results: *NextYour DetailsName *FirstLastPhoneEmail *AddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSubmit Chamber Leaders Chamber Executives
