EmailMe Form - Arkansas Community Service Awards

Nominee:

Please include information about the corporation you want to nominate for this award.

Please check one of the following *

for profit business with 50 or less employees

for profit business with 51 or more employees

Name of Corporation *

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Email *

Contact Person/Title: *

Phone *

### - ### - ####

Fax *

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Total number of employees *

Description of your corporation's projects, programs and other community service. *

Your corporation's monetary contribution to the community. This may be an approximation and may include estimated value of in-kind contributions. Please note how much of the total is in-kind. *

Policies encouraging volunteerism among your employees. *

Percentage of employees involved in community services. *

If possible, the average yearly total of hours donated to the community by your corporation's employees. *

Total impact of the corporation's contribution on the quality of life in the community/state. *

Nominator:

Please include information about you, the nominator.

Name *

First Last

Email *

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Home Phone *

### - ### - ####

Alternative Phone *

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Title & Organization *

Date *

MM / DD / YYYY

Image Upload *

File Upload