CTAM's DOROTHY ARNETT VOLUNTEER SERVICE AWARD

Nominee_____________________________________________________________

Local Group Affiliation___________________________________________________________

Nominee has been a member of local group since __________

Describe nominee’s various service contributions as a member of your group
[attach a separate sheet if necessary]
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Nominated by [see previous page for who is eligible to make a nomination]

Print Name                                      Title                                            Signature                       

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Nomination must be postmarked by July 1st to be considered
Completed nomination forms should be sent to:

TERRY JOLINK
3768 Socorro SW
Grandville, MI 49418