2018 Salute to Dealers

2018 Salute To Dealers Nomination Form

Please complete all sections of this form where applicable. Judging will be based on the information include in this form so be as detailed and complete as possible! Include additional pages if necessary.

Email all completed nomination forms to Anna Palumbo at [email protected] by Friday, August 18, 2017. If you have any questions while completing the form please contact Anna Palumbo at [email protected].

NOTE: If the Dealer you would like to nominate is the recipient of a previous Salute to Dealers award, they are not eligible to participate. Previous nominees that have not won are eligible.

Dealer Principal's Name: Dealership Name: Dealer Mailing Address: City, State, Zip & Country: Dealer Telephone Number: Dealer E-mail Address: Sales Code / P&A Code: (U.S. Only) Region: Dealer Primary Contact: (If other than Dealer) Dealer Primary Contact E-mail Address: Dealer Primary Contact Phone Number: Additional Ford and/or Lincoln Franchises (please list): Is this Dealer a previous Salute To Dealers honoree? Is this Dealer in good standing with Ford Motor Company? Summarize in one or two sentences why you are nominating this Dealer: How frequently does the Dealer donate time and services to the cause(s)? (Ex: hours per day/week, weeks per month/year, etc.) How long has the Dealer been involved in these efforts? Please elaborate in detail on how the Dealer directly contributes to their community and how they support FMC’s commitment in the area of corporate citizenship (i.e. education, health, safety, environment, etc.) Include additional pages as necessary:

If selected, would the Dealer be willing to participate in a recognition ceremony on Thursday, March 22, 2018 in Las Vegas, Nevada during the 2018 NADA Convention? If selected, would the Dealer be willing to have his/her portrait painted by an artist for display at Ford Motor Company World Headquarters? Please provide any additional information you feel is important: Nomination Submitted By: Name: Title: Telephone Number: E-mail Address: Mailing Address: Division/Organization (if applicable): Region (if applicable): Date: