2010 Pinnacle Award Nomination Form

Nominee Name and Contact Information
Name:
Address:
City:
State:
ZIP:
Phone:
E-mail address:
Award Category:

Provide a detailed narrative about the nominee's professional or volunteer work. (Provide Web site addresses if you wish to provide examples of professional work or more detailed information. Please limit your answer to 600 words or about 1 typed page):
Describe the nominee's impact on the community's civic, charitable, cultural, or economic well-being (Please limit your answer to 600 words or about 1 typed page):
Summarize the nominee's local, regional and national recognition (Can include awards, presentations, exhibitions, distinctions, etc. Please limit your answer to 600 words or about 1 typed page):
Present connections to the Library's mission and values with the nominee's personal or professional mission and values (A link to the Library's mission and vision is listed below. Please limit your answer to 600 words or about 1 typed page):
	Library's Mission and Values

Nominator Name and Contact Information
Name:
Address:
City
State:
ZIP:
Phone:
E-mail:

Reservations for Pinnacle Award Recognition Dinner
Pinnacle Award winners will be recognized on Thursday, October 28, 2010; 7 p.m. at the Regnier Center, Johnson County Community College. Because seating is limited, early reservations are recommended.	Pinnacle Sponsors $3,000 Dinner Sponsors $1,000 Table Sponsors $500 Ticket Four-Pack $300 Individual Ticket $75

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