2016 NPD Awards Nomination Survey

* 1. Award Category

* 2. Name of Nominee and Contact Information

* 3. Name of Nominator and Contact Information

* 4. Why are you choosing to honor this person/organization/company?

* 5. How has the nominee inspired and motivated the community in the practice and philosophy of philanthropy?

* 6. How has this effort enhanced the quality of life in Southwest Missouri?

* 7. Nominee's current and past affiliation(s) with non-profit organizations (Please note participation level, dates of service, contact person.)

* 8. Please list memberships in civic clubs and organizations:

* 9. Additional Comments you would like to provide to the committee: