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Westchester Family YMCA

NOMINATION FORM FOR THE HOWARD DROLLINGER ACHIEVEMENT AWARD

The Howard Drollinger Achievement Award to be presented by the Drollinger Family at the Westchester Family YMCA Kids Need Heroes Luncheon Thursday, September 26, 2013.

NOMINATION INSTRUCTIONS

To receive the “Howard Drollinger Achievement Award” an individual must

1) be a business leader, educator or professional service provider who has

2) made a meaningful commitment of time, talent or treasure that has had a significant impact on the Westchester/Playa del Rey community

3) focused that commitment on the betterment of Westchester/Playa del Rey through philanthropic contributions that strengthen the foundations of our community. Nominees may be honored for their work on a particular project or for their overall efforts in a wide variety of areas.

A committee of previous awardees and YMCA Volunteers will review the applications and present three finalists to the Drollinger Family Charitable Foundation, who will select the recipient of the award. The recipient of the award will receive $5,000 to be given in his/her name to the 501(c)3 charity of his/her choice at the Westchester Family YMCA’s annual “Kid’s Need Heroes” luncheon.

Nominator should be specific and use examples in describing the outstanding work of their nominee since only the information on the application itself will be considered by the committee.

If you have any questions, please call Blair McBirney at 310 625 9156
DEADLINE August 23, 2013
All information received on this form will be confidential.

Please complete the following information: