Nominations are due by Wednesday, January 16, 2019

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The J. Walter Juckett Award is the 4-county region's prestigious community service award, given to recognize and honor an extraordinary individual who has selflessly gone above and beyond by contributing time and energy to help others. 

NOMINATING CRITERIA:

1. The nominee's profile should demonstrate significant contributions to the community in the field of human services, education, business or industry.
2. The nominee's contributions should be substantial and enduring.
3. The nominee should reflect the admiration of his or her peers.
4. Neither the nominee nor nominator are required to be a member of the Adirondack Regional Chambers of Commerce (ARCC) to be considered to receive this honor.
J. WALTER JUCKETT AWARD NOMINEE INFORMATION

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* 1. Nominee's Name:

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* 2. Company Name (if applicable):

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* 3. Phone Number (to contact nominee):

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* 4. Email Address of Nominee:

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* 5. Address of Nominee

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* 6. Please explain (in 300 words or less) why this individual should be considered for the 2019 J. Walter Juckett Award.

NOMINATOR INFORMATION

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* 7. Nominated by:

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* 8. Best method to contact you, the nominator (please provide details):

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