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Sound Shore Nomination Form for
The Dorothy Allen Community Service Award and/or
The United Way of Westchester and Putnam Service Award

Awards to be presented on November 9, 2011 at the
Sound Shore Leadership Dinner
Beckwith Pointe, New Rochelle

Due July 15, 2011 by 5:00pm

Award *
Dorothy Allen Community Service Award
United Way Service Award
Name of Nominee *
Address
State
Zip
Phone
Alternate Phone
E-mail Address *
Which community is s/he involved in? *Harrison
Larchmont
Mamaroneck
New Rochelle
Pelham
Port Chester
Purchase
Rye
Rye Brook
Your name *
Address *
State *
Zip *
Phone *
Alternate Phone
E-mail Address: *
What is the best way to contact you?
Please explain how this person "Lives United" or shows excellent characteristics of a Community Leader. *

Example: A person who inspires others through his/her own actions. she has made a difference by giving a significant amount of his or her time through community service, community pride and/or community leadership for noteworthy improvements.

(If selected, a portion of the biography / explanation will be read at the ceremony and included in the program book)
* Required

If you have any questions or would like any further information
please email Shelia Abrams or call at (914) 997-6700 ext 741

Honorees will be selected by a special Committee composed of
United Way of Westchester and Putnam Staff and Community Volunteers

***Awardees will receive a letter in the mail***
Nominators will be notified by phone/e-mail after letters are mailed out.