2009 Nominations Nomination Form

When

Nominations are open from June 11, 2009 through August 31, 2009. Nominate your Symetra Group Community Champion by clicking on and following the prompts.

Who is a Group Community Champion?

A Group Community Champion is someone who has demonstrated a significant commitment to volunteer service providing long benefits to the community.

Your Group Community Champion nominee must be affiliated with a civic, cultural, health or human service organization, which are tax exempt under Section 501(c)(3) of the U.S. Internal Revenue Code. Private schools with at 501(c)(3) designation and all public schools including day care, K-12, colleges and universities are also eligible.

The nominating Broker or Producer must identify the organization to receive the prize funds in the event his nominee is chosen.

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Nominate your Group Community Champion

Your Name * Who can nominate guidelines.
Company Name *
City *
State *
Phone *
Email Address *
Nominee's Name *
Describe how you know
your nominee *
Nominee's Affiliated
Nonprofit Organization *
For ineligible organizations and activities please see guidelines.
Describe how your nominee
has given a lifetime of
volunteer service providing
long term benefits to the
community *
* Denotes a required field.