ICBM Legacy Award Nominee Form 2020 Question Title * 1. Nominee Information Name (first and last) * Company * Title * Address City * State * Zip * Email Address * Phone Number * Question Title * 2. List the full name you would like inscribed on the award if different than above. Question Title * 3. How many years has the nominee been in the industry? Question Title * 4. Please provide as detailed a career history as you can: (Years for major position changes are the most helpful.) Include the nominee's most memorable moment in banking, and outside activities and interests. Question Title * 5. List the nominee's key career accomplishment(s) or their personal highlights. These can include community support or banking-related activities. Question Title * 6. This nomination has been submitted by: Name Company Title Address City State Zip Email Address Phone Number Question Title * 7. How would you describe the nominee? What makes them a good coworker or employee of the bank? Question Title * 8. If you’d like us to include a quote from you in the nomination, submit it here: Question Title * 9. How would the nominee like the award to be delivered? In person at the bank (We will call you to set up a date and time) Via mail (Provide mailing address below in comment box) Mailing Address SUBMIT