 |
|
|
| 2009 Good Neighbor Awards Entry Form Application Deadline: Friday, May 22, 2009 Please print this page and complete; attach additional pages as needed. Mail FIVE COPIES of the completed entry form and attachments to: Good Neighbor Awards REALTOR® Magazine 430 N. Michigan Ave. Chicago, IL 60611 Nominee Name: ____________________________________________________ Company: __________________________________________________ Address: ___________________________________________________ __________________________________________________________ Phone: _________________________Fax: ________________________ E-mail: ________________________Web site: _____________________ Real estate designations (GRI, CRS, etc.):___________________________ Birth date: __________________________________________________ Social Security number: ________________________________________ Local REALTOR® Board: _______________________________________ Phone: _______________________Web site:_______________________ Nominee's broker/manager: _______________________Phone:_________________ NRDS ID#: __________________________________________________ (Obtain your ID# at www.realtor.org. Log in or register there, and click on "NRDS" to search for your number. You can also find your ID number printed above your name on the REALTOR® Magazine mailing label.) If you're completing this application and you're not the nominee, please also provide your Name: _____________________________________________________ Company/charity name: _________________________________________ Address: ___________________________________________________ __________________________________________________________ Phone: _________________________E-mail: _______________________ Relationship to nominee: _________________________________________ Community Program(s) Served (This organization will receive the grant money if you are selected as a Good Neighbor Award winner. If there's more than one, please add a page.) Organization name: ___________________________________________ Address: ___________________________________________________ __________________________________________________________ Phone: __________________________ Fax: _______________________ E-mail: __________________________ Web site: ____________________ Nature of the community work the nominee performed (brief description of the organization's mission and the candidate's contribution): ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ How long has the nominee been volunteering with this organization?__________ Who may we contact at the organization to verify the nominee's involvement? Name: ________________________________________________________ Company/charity/title:_____________________________________________ Address: ______________________________________________________ _____________________________________________________________ Phone: _____________________________ E-mail: ____________________ Personal Contribution (Nominees should have made a significant contribution of personal time, but contributions of money, materials, or other resources will be considered by the judges.) Note: This information is required. Although you may not keep exact records, we must have your best estimatein order to evaluate the entry. Unpaid hours the nominee personally contributed to this organization from January 2008 to present (approx. 16 months): _____________________________ Volunteer hours the nominee personally recruited from others to work for this organization from January 2008 to present (approx. 16 months): _______________ Dollars, materials or other resources the nominee personally contributed to this organization from January 2008 to present (approx. 16 months): ________________ Dollars the nominee personally raised for this organization from January 2008 to present (approx. 16 months): _____________________________ Number of people served by the nominee (approx.):_________________________ Is the nominee compensated for any portion of the service work described in this application. (If yes, please explain.) _________________________________ ____________________________________________________________ Does the nominee perform the community service as part of his or her duties as an employee or corportate officer of a real estate company? (If yes, please explain.) ____________________________________________________________ ____________________________________________________________ Explanation of Contribution (Required) In no more than 500 words, describe how the nominee's individual efforts have made the community a better place to live. (Use separate page.) Verification of Involvement (Required) Please attach published reports or testimonials from the organization or individuals served that document the nominee's activities. These documents should attest to the individual involvement of the nominee. Please highlight the nominee's name in documents where it is not immediately evident. (List the attachments here.): ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ I certify that to the best of my knowledge, all of the information provided is true and accurate. Signature: ___________________________________ Circle: I am/am not the nominee. Who should we notify about the Good Neighbor Awards results (August 2009): Name: __________________________________________________ Company/charity: __________________________________________ Address: ________________________________________________ _______________________________________________________ Phone: _______________________E-mail: ______________________ Mail FIVE COPIES of the completed entry form and attachments to: Good Neighbor Awards REALTOR® Magazine 430 N. Michigan Ave. Chicago, IL 60611 Deadline: Friday, May 22, 2009,5:00 p.m. CST Questions? Browse the Good Neighbor FAQs , contact NAR's Information Central at 800/874-6500 or Sara Geimer at sgeimer@realtors.org |
| Are You Good Neighbor? |
| Good Neighbor Home Entry Form FAQs Rules Grants & Prizes Press Release  |
| Good Neighbor Tool Kit |
| Becoming a Volunteer Leading a Charity |
| Past Winners |
| Read Profiles Watch Videos TV Campaign Contribute to Charities Good Neighbor Q&A Good Neighbor Society Discussion Board Search the Good Neighbors |
| Volunteering Works |
| New Mentoring/Grant program |