CHARLES H. FLYNN HUMANITARIAN AWARD


Application for the 2010 Charles H. Flynn Humanitarian Award is now closed. Any new nominations will be kept on file for 2011. Simply fill in the required information and click on submit. If you have any additional questions, please e-mail them to valleyunitedway@valleyunitedway.org.

On-Line Flynn Nomination Form

Basic information about nominee:
 

Nominee's Name:

Address 1:

Address 2:

City: State Zip: 

Phone:

E-mail:

Personal Information:
Spouse Name:

Children:

 

Occupation:

Education:

Community Activities:

Professional and/or Community Affiliations:

Honors or Awards which demonstrate recognition of achievement and/or community service:

Comments:

Person submitting nomination (optional):
Name:

Work Phone:    Fax:

E-mail Address:

      

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