6.0 Community Service Award Request

6.0 Community Service Award Request

Background: This award is presented to a member of the Institute of Management Consultants USA for outstanding contributions to their community. This can be a Chapter or a National award.

This recognition is awarded to an individual who:

● Has performed a critical service for their community surrounding an event of significant importance, e.g., hurricane / disaster relief efforts, etc.

● Has been involved in a sustained project over a long period of time, e.g., Oak Tree project, etc.

● Has created strong, long-term support of IMC USA in multiple venues,

● And has earned a reputation for uncommon, excellent performance, and whose value to IMC USA is easily recognized by others in our organization.

Process: This application is submitted to either the Chapter President or the IMC USA Executive Director (as appropriate). Upon approval, the recipient will be notified at least four (4) weeks prior to the event at which the Community Service Award is to be presented.

Awards are presented by Chapter Presidents, the IMC USA Chair, or the IMC USA Committee Chair at a Chapter, Regional, or National meeting as appropriate. Ideally awards would be presented in the decorum appropriate to the award at a local or national event, conference or annual meeting.

When a chapter award is approved, a copy of this application is to be retained by the Chapter and the Chapter Board meeting minutes record the Board’s approval, and a copy will be forwarded to the Executive Director for retention. When a national award is approved, a copy of this application is to be retained by the Executive Director along with a copy of the IMC USA Awards Committee’s approval.

To initiate the process, please provide the following information:

Nominee Personal Information

Name (nominee)______(If a CMC®, year earned) ______

Company name ______Phone number ______

Address ______

City ______State ______Zip ______

Chapter Affiliation ______(“At Large” if not a member of a local chapter)

Is candidate aware of nomination? Yes No

Candidate Web page address______E-mail address ______

Community Service (reason award is requested)

q Distinguished community services for IMC USA Chapter ______

Chapter Name ______

q Distinguished services for IMC USA

Describe distinguished services and achievements (please be as specific as possible):
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IMC USA Service

Chapter offices held (include date): 1. ______2. ______

3. ______4. ______5.______

National offices held (include date): 1. ______2.______

3. ______4. ______5.______

Chair positions held (include date): 1. ______2.______

3. ______4. ______5.______

Awards received from IMC USA:

Award #1 ______From: ______Date ______

Award #2 ______From: ______Date ______

Award #3 ______From: ______Date ______

Award #4 ______From: ______Date ______

Other accomplishments for IMC USA and/or Community:

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Description of consulting practice:

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______
______

______

Sponsor Affirmations

Sponsorship of this application requires five (5) IMC USA member signatures (three (3) members must be CMCs). Sponsors may be contacted to answer specific questions regarding the candidate’s application.

CMC® Sponsor #1 ______Date ______