Fahey Five Hundred

Nomination form
In these difficult times many members of our community are facing challenges -- and many others
are rising up without recognition to help those in need. So, every single day between Thanksgiving
and Christmas Fahey Bank will donate $500 to a member of our community in need, or to someone
who is working without recognition to make our community better. Let us know about someone
special who has been laid off, or is sick, or has a special need, or about a health care worker, first
responder, teacher, service member, clergy member, charitable organization or someone else
showing their dedication to the people of our community who deserves recognition and thanks.

Nominee

Name:

Organization: (if applicable)

Phone:

Email:

Address:

Tell us what is special about this person or organization, and why you nominated them.

Nominator. Please consider the person or organization named above. I can personally vouch for
them and their need or contribution.

Name:

Phone:

Email:

Address: