Delta County Area Chamber of Commerce

ATHENA AWARD NOMINATION FORM

NOMINEE
Name:
Title or Position:
Company:
Business Address:
City:
State:
Zip:
Business Phone:
Home Phone:

NOMINATOR
Name of Nominator:
Company Name:
Business Phone:

ASSISTS WOMEN IN REACHING THEIR FULL LEADERSHIP POTENIAL:
Provide specific examples of how the nominee has demonstrated support for the advancement and leadership devlopment of business and professional women.

BUSINESS ACCOMPLISHMENTS
List special recognitions, projects and achievements. Include business-related affiliaions, directorships, trusteeships or other designations.

COMMUNITY SERVICE
Describe local, state, and national level participation, length of service and offices help in civic and service organizations, charitable activities, political pursuits, religious groups, chamber of commerce, merchants' associations, etc.

OTHER MEMBERSHIPS, ACHIEVEMENTS, AWARDS, PUBLICATIONS
Nominees may already have been honored for service to their profession, industry or community. They also may have publications to their credit or articles published supporting their service to their profession, industry or community. Please list awards and honors received which support this nomination:

ADDITIONAL INFORMATION PERTAINING TO CRITERIA:
Discuss briefly factors you feel are important for consideration of your nominee for the ATHENA Award.

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