NATIONAL LIQUOR LAW ENFORCEMENT ASSOCIATION CHARTERED 1988 2012 AWARD

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LIQUOR LAW ENFORCEMENT OF THE YEAR:

National Liquor Law Enforcement Association

Chartered 1988

2012 Award Nomination Form

Instructions: Please fill out the form below for the appropriate category in which you wish to nominate an individual or an agency. The deadline for receiving the 2012 Nominations is Friday, June 15, 2012. While we prefer that you email this document along with any supporting documentation to [email protected], you may mail or fax the nomination form to:

National Liquor Law Enforcement Association

11720 Beltsville Drive, Suite 900

Calverton, MD 20705

Fax: 301-755-2799

Liquor Law Enforcement Agency of the Year:
Agency				Nominator
Director/Chief				Agency
Address				Phone
Basis of Nomination: (Attach additional sheets if necessary)




Liquor Law Enforcement Agent of the Year:
Name				Nominator
Rank				Agency
Agency				Phone
Basis of Nomination: (Attach additional sheets if necessary)



Innovative Liquor Law Enforcement Program of the Year:
Agency				Nominator
Director/Chief				Agency
Address				Phone
Basis of Nomination: (Attach additional sheets if necessary)



John W. Britt Community Service Award:
Name				Nominator
Rank				Agency
Agency				Phone
Basis of Nomination: (Attach additional sheets if necessary)

Please note: The director of the agency/officer nominated must approve all nominations, either via signature on this form or via an email to [email protected] approving the above nomination. Nominations that are submitted without the approval of the director will not be reviewed.

I approve the nomination of this agency/officer for the 2012 NLLEA Awards.


Signature		Date


Printed Name		Title

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