2008 ONLINE AWARD ENTRY FORM — Due March 10, 2009

Please fill out the online entry form completely. In addition, if your company has any literature, brochures or photos that help describe your efforts, you may send them to ICMA at 191 Clarksville Road, Princeton Junction, NJ, 08550, USA. Please note that the program must have been in effect between October 2007 and March 2008 to be eligible for this year's Award.

Name of Company:
Contact Name:
Address:
Address 2:
Country:
Phone:
Fax:
E-mail Address:
Web site:
Descriptive Name of Your Company's Program/ Charitable Effort :
Brief Overview of the Program/ Charitable Effort (25 words or less):
Detailed Description including Parameters, Reasons for Implementation, Goals, Successes The following questions may help you when describing your program on the entry form. Be sure to describe the original community need, your efforts / activity in response to that need, and the overall impact, i.e. the success or outcome. Describe how the activity was implemented and how it improved the lives of those involved or how it benefited society. What prompted your company to initiate this program? How long has the program been in place? Who exactly did the program benefit? (use numbers or quantifying descriptions where possible) What did the effort ultimately achieve? (again use numbers or quantifying descriptions where possible) What was the level of involvement of your company staff and how was their involvement solicited?
Is the program ongoing or a one-time effort? Ongoing One-time
Number of company staff involved:
If hands-on service was contributed, how many total hours do you estimate were donated by your company staff?
Total amount of cash contributions, if applicable (refers to actual financial contributions, donations, etc) US$
Total value of in-kind contributions, if applicable (refers to value to materials, labor, land, etc. being contributed to project) US $
Date / Timeline for Program: