2010 Nominations 2010 Nominations 2010 Nominations Nomination Form

When

Nominations are open from June 11, 2010 through August 31, 2010. Nominate your Symetra Community Champion by filling out the form below.

Who is a Symetra Community Champion?

A Symetra Community Champion is someone who is working to make a positive difference in his or her community.

Your Symetra Community Champion nominee must be affiliated with a civic, cultural, health or human service organization, which is 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 / producer must identify the organization to receive the prize funds in the event his or her 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
is working to make a
positive difference in his or
her community *
* Denotes a required field.