The DBLAs: Local Biz Awards Nomination Form
This is the second year for the DBLAs: Local Biz Awards. During the October 5 event, Dane Buy Local members will be recognized for inspiration, involvement, achievement, and leadership in their neighborhoods, their communities, and Dane Buy Local. Winners will be announced the night of the event.

· Nominees in all categories must be a member in good standing of Dane Buy Local

· Nominees must serve as an inspiration to other locally-owned, independent businesses and be involved in their neighborhoods and/or communities and Dane Buy Local

· Nominees can win in only one category

· A winner can receive an award only once every 3 years

· All awards will be made at the discretion of the selection committee

NOMINATIONS ARE DUE SEPTEMBER 12, 2017.

Please note: Some information needed below may require interviewing the potential award winner. Self-nominations are also welcomed.

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Name of Nominated Business *
Contact Person *
Email *
Address *
Phone number *
Website *
Number of years in business
Number of employees, including owner *
Dane Buy Local Member since? (If unknown, leave blank)
Choose an Award Category (from Dane Buy Local Guide):
Clear selection
Submitted by: Name *
Email *
Phone *
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