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)

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Submitted by:__________________________________________________________________________

Telephone:_____________________________________

Please return by Feb. 28th, 2015 to:

River Valley Chamber of Commerce

10 Bridge St.

Rumford, ME 04276