American Indian Chamber of Commerce American Indian Individual by alicejenny


									                                     American Indian Chamber of Commerce of Texas
                                      AMERICAN INDIAN INDIVIDUAL OF THE YEAR

Company Full Name: ______________________________________________________________

Representative Name/Title: _________________________________________________________

                 To officially enter the selection process you must respond to the criteria by
             Friday, September 28, 2012. Mail or fax your completed questionnaire and answers
                                      (answers may be on a separate page)
                                                Awards Committee
                                American Indian Chamber of Commerce of Texas
                                           11245 Indian Trail, 2 Floor
                                               Dallas, Texas 75229
                               E-mail or Fax 972 – 241 – 6454
                                           CRITERIA                                            Total SCORE
                                                                                                100 Points
I. Chamber Participation     (30 Points)

    A.   Describe the Chamber activities in which you have participated in the past year.           (15

     B. Give examples of the leadership role you assume in Chamber activities.          ( 15 points)
II. American Indian Business Community Involvement (30 Points)
     A. Describe your involvement in American Indian Business Development outside of A.I.C.C.T.
         Chamber activities in the DFW area. If you have been involved in the development of
         American Indian Businesses on a State, Regional or National level please describe those
         activities. (30 points)
III. Personal Success (20 Points)
     A. Tell about the experiences you had as an MBE individual and supporter of the Chamber. (10
     B. Provide biographical information of your successes in one paragraph, no
        longer than a half of page. (If you are selected for this nomination, the
        information will be used for the awards program or during the banquet event).
        (10 points)
IV. Leadership (20 Points)
     A. Which issues will be the biggest challenge to the growth of community
          Programs in the near future? (10 points)

    B. What leadership role will you play, in successfully facing these
       challenges?       (10 points)

                                                    Truth of Information/Release

The information provided is true and complete to the best of my knowledge and belief. I agree that if I am selected as an award
recipient, I hereby authorize the release of my name and/or likeness, sound and/or voice recording, photographs, stills, video and all
forms of technological media production, to the American Indian Chamber of Commerce of Texas, for use at its discretion, in
connection with its American Indian Individual of the Year Awards Program. I understand that no compensation, of any sort, shall be
due me for such usage.

Completed by: ___________________________________________ Title: ___________________________________        Date: __________________                                                            Supporting the American Indian Community Since 1988

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