COMMUNITY MERIT AWARD

Sponsored By

This award is designed to recognize organizations and/or events, including churches and charitable fundraisers, which contribute to the overall quality of life and economy of the community.

Please complete this application in its entirety. Please restrict your comments to the specified word count as defined; point form may be used. Microsoft Word documents will be accepted in electronic format. Any attachments, other than requested references, will not be reviewed.

Please call the Yorkton Chamber office (306-783-4368) if you have any questions. Application deadline is February 29, 2016.

Is this a nomination for an organization? Yes Noo If yes, please complete Section 1

Is this a nomination for an event? Yes Noo If yes, please complete Section 2

SECTION 1 Organization1. Please provide a brief description of your oganization. (25 words maximum).

2. Describe the ways in which the organization has contributed to the overall quality of life and to the economy of the community. (300 words maximum).

3. For how many years has this organization been in the community? (25 words maximum).

4. What is the total membership of the organization as of Dec 31, 2015?

5. Please list the local partners, if any, in the community.

6. Describe any provincial and/or national exposure the organization has received for its work in the Yorkton community. (50 words maximum)

SECTION 2 Event7. Please provide a brief description of the event. (25 words maximum)

8. Describe the ways in which the event has contributed to the overall quality of life and to the economy of the community. (200 words maximum).

9. For how many years has this event been held in the community? (25 words maximum).

10. How may paid staff?

11. How many volunteers? Estimated number of volunteer hours?

12. How many visitors, competitors, spectators, officials, etc does this event attract to Yorkton?

13. What is the most significant contribution or legacy this event has given to Yorkton? (50 words maximum)

14. Describe any provincial and/or national recognition the event has received. (50 words maximum)

Name of Organization or Name of Event ______________________________________________

In the case of an Event, name the sponsoring organization _______________________________

CONSENT

I hereby consent to have my nomination considered for the Yorkton Chamber of Commerce Celebrate Success Business Awards. I have read and comply with the rules of eligibility.

Name of Authorizing Person (please print) ________________________________________

Signature of Authorizing Person ________________________ Date ___________________