River Valley Chamber
Annual Awards Nomination Form

1.Award Category:________________________________________________________________

2. Nominee’s Name:_______________________________________________________________

3.Brief summary of your reasons for nomination:________________________________________
(use separate sheet if necessary)
____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

Submitted by:__________________________________________________________________________

Telephone:_____________________________________

Please return by March 1, 2010 to:
River Valley Chamber of Commerce
10 Bridge St.
Rumford, ME 04276