Nomination Application - ERC5 Chamber

Nominee's Contact Information

Nominee's Name *

Job Title / Position *

Current Company Name *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal code *

Country

Honoree's Email Address *

Company Phone Number *

Nominated By (Your Information)

Your Name *

Job Title / Position *

Company Name *

Email Address *

Phone Number *

Nomination Statement

Why This Member Deserves ERC5 RecognitionPlease provide 400 to 500 words explaining why this member stands out and deserves to be recognized for ERC5. You may submit a written statement, a video, or both.

Video Upload (Optional)

Video NominationYou may provide a video nomination along with, or in place of, your written statement. Videos may not exceed 2 minutes in length or 2 MB in size. Accepted file types: jpg, png, pdf, doc, tiff, avi, flv, wmv, mov, mp4.

No file chosen

Supporting Documents

Supporting DocumentsSupporting documents such as resumes, press articles, awards, and commendations may be uploaded here. Accepted file types: jpg, png, pdf, doc, docx, tiff, avi, flv, wmv, mov, mp4. Max file size: 2 MB per file.

Nominate a Member for ERC5 Recognition

Nominee's Contact Information

Nominated By (Your Information)

Nomination Statement

Video Upload (Optional)

Supporting Documents

Become a member of the ERC5 Chamber today!

280 North Main Street

East Longmeadow, MA 01028

(413) 575-7230