The Warner Robins Area Chamber of Commerce would like to thank the following sponsors:
 

THE RALPH JOHNSON DISTINGUISHED
LIFETIME BUSINESS ACHIEVEMENT AWARD
NOMINATION FORM

Thank you for participating in the nomination process for this prestigious award.

1. Self-nominations are allowed, but all applicants must be a small business and a member of the Chamber.

2. Potential winners will demonstrate the following criteria:

  • Is an active Chamber member in good standing
  • Has been in business for 30 years or more
  • Has a proven history of voluntary efforts and endeavors to advance small business and impact the community
  • Has demonstrated success and growth as a small business
  • Demonstrates other accomplishments demonstrating merit as an effective advocate for small business interests
PLEASE PROVIDE THE FOLLOWING INFORMATION ON YOUR NOMINEE...
COMPANY NAME
MAIN CONTACT/OWNER
ADDRESS
CITY
STATE  
ZIP
PHONE
FAX
E- MAIL
WEBSITE
OWNERSHIP STATUS c-corp    s-corp    LLC
partnership     sole proprietor
TYPE OF INDUSTRY
YEAR FOUNDED
NAMES OF FOUNDERS
CURRENT LEADERSHIP (Please list names and titles for each person)
PLEASE LIST IN 150 WORDS OR LESS, WHY THIS BUSINESS SHOULD BE CONSIDERED FOR THE AWARD.

 
YOUR NAME (REQUIRED)
YOUR PHONE (REQUIRED)
YOUR E-MAIL (REQUIRED)