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LoudoUn County

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Please complete the entire form, all fields are required. Incomplete forms will not be considered. If you have any questions, please contact Roxane Remley. Nomination deadline is: September 3, 2010 at 5:00 PM EST. You can nominate as many businesses as you would like but you will only need to submit on nomination for each organization. Eligibility requirements or a copy of the PDF form to fax and/or mail are also available.

 

2010 SMALL BUSINESS AWARD NOMINATION

Organization being nominated:
Organization
First Name
Last Name
Address
City
     
Phone
Fax
Email
Website
Nonprofit?
 Yes No
Submitted by:
Organization
Name
Phone
Email

  

Thank you for your nomination.