Prince William County-Greater Manassas Chamber of Commerce
14th Annual Shelley Krasnow Community Service Award
2003 Nomination Form
Nonprofit Organization and/or Program:
Nonprofit Organization and/or Program Director:
Contact Person:
Phone:
Address:
Nonprofit Status:
 501(c)3 501(c)6
Other
Is the Organization a Current Member of the PWC-GM Chamber?
 Yes No
(You May Wish to Contact the Chamber to Check the Current Status, 703.368.6600)
Nomination Submitted By:
Company:
Phone:
Mission Statement of Organization:
Who does the Organization/Program Serve?
What are the Accomplishments of the Organization/Program in the last year?
Describe the Organization's/Program's Impact on the Community and on the Quality of Life of those served.
Please write, in 25 words or less, how you would like your organization described to the general public if you were the recipient of the Shelley Krasnow Service Award. (This piece will be used to describe your organization at the event and may be used in Chamber publications.)
Any Additional Information.
Nominations must be received by 12:00 Noon on or before Friday, January 24, 2003
at the Chamber office, 8963 Center Street, Manassas, VA 20110.
Copyright �1998 - 2003 Prince William County-Greater Manassas Chamber of Commerce, all rights reserved.
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