GOVERNOR'S INDUSTRY APPRECIATION LUNCHEON HONOREE NOMINATION FORM
Southern Nevada Companies: period from JAN. 1, 2001 to DEC. 31, 2001
Northern Nevada Companies: period from JULY 1, 2001 to JUNE 30, 2002

NEVADA LOCATION:
Company Name:
Local Contact:
Title:
Physical Address:
Mailing Address:
City:
State:	NV
Zip Code:
Phone:
Fax:
E-Mail:
Web Site Address:
Yes No	If selected as honoree, can the above information be printed in the program booklet?
CORPORATE/HEADQUARTERS LOCATION: (if applicable)
Corporate Name:
Contact:
Title:
Mailing Address:
City:
State:
Zip Code:
Phone:
Fax:
E-Mail:
Web Site Address:
BUSINESS TYPE:	Manufacturing Distribution Service
PRODUCT MARKETED/ DISTRIBUTED IN:	Nevada West Coast United States International
PRODUCT EXPORTED TO: (Identify country/countries)
PRODUCT/SERVICE DESCRIPTION:
COMPANY IS: (Check appropriate description)	New to Nevada as a: relocation expansion Startup business Expansion of an existing Nevada business
"NEW" TO NEVADA BUSINESS: (Complete this section only if new to Nevada)
Date or anticipated date of opening:
Number of employees in Nevada at opening:
Number of employees in Nevada at present time:
Number of employees in Nevada anticipated after 1 Year:
Facility is:	Leased Owned
Total square footage:
If a relocation or expansion, from what:	CITY : STATE :
REASONS FOR MOVING BUSINESS TO NEVADA:
"EXPANSION" OF A NEVADA BUSINESS: (Complete this section only if a Nevada business expansion)
Year established:
Number of employees added as result of expansion:
Current total number of employees:
If physical expansion, is facility:	Leased Owned
Square footage added:
Date or anticipated date of completion:
REASONS FOR EXPANDING IN NEVADA:

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COMPLETE THIS FORM AND RETURN BY: Southern Nevada Companies: return by March 1, 2001
Northern Nevada Companies: return by July 2, 2001
For further information or questions, contact Menyone Thomas at the Nevada Commission on Economic Development at [email protected] or phone (702) 486-2700 / toll-free (800) 336-1600.