Dr. Gene McFadden Award Survey

This award is presented annually to a certified Minority Business Enterprise entrepreneur who represents the qualities of the late Dr. Gene McFadden, owner of Freight Masters.

DEADLINE: October 25, 2019

Entrepreneurial Spirit
The entrepreneur has taken a vision and turned it into reality through the development of innovative business, products or valuable new services, or one which has adapted and/or improved a current product or service.

Community Support
The entrepreneur’s civic and community service goes beyond “normal” responsibilities, creating a lasting and beneficial impact in their community or in the world. This person has set an example for commitment to public service, while maintaining a strong business and community image.

Mentoring
The entrepreneur has not only made their mark in the world of business, but has helped other emerging entrepreneurs, youth and professionals through mentoring.

Question Title

* 1. Please enter the name and contact information for the person you are nominating.

Name

Company

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

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* 2. Is he/she the business owner?

Yes

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* 3. Please rank (based on your opinion and knowledge) the person's level of engagement/involvement in each of the categories.

	1 (Low)	2 (Moderate)	3 (High)
Entrepreneurial Spirit	Entrepreneurial Spirit 1 (Low)	Entrepreneurial Spirit 2 (Moderate)	Entrepreneurial Spirit 3 (High)
Community Support	Community Support 1 (Low)	Community Support 2 (Moderate)	Community Support 3 (High)
Mentoring	Mentoring 1 (Low)	Mentoring 2 (Moderate)	Mentoring 3 (High)

Use the space below in each box to describe the accomplishments of the nominee according to the guidelines above.

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* 4. Entrepreneurial Spirit (See guidelines above)

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* 5. Community Support (See guidelines above)

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* 6. Mentoring (See guidelines above)

PLEASE NOTE: The individual being nominated MUST be currently certified by the Mid-States MSDC and MUST be the owner of the business. Current Mid-States MSDC corporate members, certified MBEs and/or their employees may nominate an individual. The MBE owner may also self-nominate.

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* 7. Your Information. Please provide your information (as the nominator) below.

Name

Company

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Thank you for completing the nomination form. We will be in touch soon. All nominees will be notified of their nomination and the winner will be announced at the event.