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Time to Care Award Nomination Form
1.Nominee's Contact Information
Name of Nominee*
Address*
City*
State*
Zip*
Daytime Phone*
2.Nominator's Contact Information
Nominator's Name*
Nominator's Phone*
3.What has the nominee done to impact the community?*
4.Why should the nominee be selected as the Time To Care Award Winner?*
* represents required fields
Mailing Address: P.O. Box 1212 Augusta, GA 30903 Main Telephone: (803) 278-1212 Newsroom: (803) 278-3111 Fax: (803) 442-4561
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