Leadership Anne Arundel’s
Annual
“Tribute to Community Leadership”
Distinguished Graduate Award
Official 2013 Nomination Form - Deadline June 1, 2013
Criteria
The purpose of this award is to recognize exceptional Leadership Anne Arundel graduates. Recipients are men and women who have adopted "the heart of community trusteeship" and have made significant and notable contributions for the betterment of their communities.
Recognition
The Distinguished Graduate will be honored at the Tribute to Community Leadership graduation event on June 19th.2013
Nominations may be made by any Leadership Anne Arundel graduate or current class member.
Eligibility
• The recipient must be a graduate of any Leadership Anne Arundel program, AND
• The recipient must live or work in Anne Arundel County AND
• The recipient must have exhibited his\her leadership in their employment or in a voluntary capacity.
Please complete the nomination form (attached) and return it by June 1, 2013 via mail: Leadership Anne Arundel, 2049 West Street, Suite 205, Annapolis, MD 21401; fax: 410-571-0165; or email: The information included on the form will be considered confidential and will be used only by the Selection Committee. If you have questions, contact Bill Kuethe @ 410 437-1145 or Eric Edstrom @ 410-279-1969
Nomination for 2013 Distinguished Graduate Award
NOMINEE’S Name ______
First Last LAA Class Yr.
Title______Company/Organization ______
Business Address ______Email______
City______State_____Zip______Phone ______
NOMINATOR______LAA Class Yr. ______
Nominator's Company/Organization ______
Nominator's Business Address ______
City______State_____Zip______Phone______
Email address: ______
Cite your reasons for nominating this individual based on their commitment, courage, and positive contribution in a leadership role. Be specific. (Use addendum if necessary)
Please list two individuals who are aware of the nominee's leadership contributions and may be contacted as references.
Name and Title ______
Company/Organization ______
Area Code and Telephone ______
Name and Title ______
Company/Organization ______
Area Code and Telephone ______
Public Relations Opportunities (Optional)
In the interest of giving the nominee public relations exposure, briefly relate stories or anecdotes on a separate page about this person's leadership style that will differentiate him/her from all others and would be of interest to the media.
Signature______Date______