Your Name
_____________________________________________________
Address
_____________________________________________________
Phone #
__________________________
Affiliation, if any,
with the company ___________________________________
Name
of Palm Beach County Business / Company you are nominating:
Contact Person
________________________________________________
Address
________________________________________________
Phone Number
________________________________________________
Please document below
in 500 words or less (print or type) any facts and information about this
company relating to the considerations listed, or any other positive reasons
that would support the company’s worthiness of this award. You may continue on the back of this form if necessary.
