Montana Land Title Association
2012 Executive of the Year
REQUIREMENTS:
1. Nominee must be an owner or manager of an MLTA office.
2. Nominations should include, but need not be limited to, the following information regarding the Nominee:
- Length of service to the Title Industry
- Membership and contribution to the MLTA and the Title Industry in general
- Civic and community services
- Character
- Employment History
- Education
- Family
NOMINEE: _________________________ 
__________________________ (Name) (Office)
____________________________ _____________________________ (Job Title) (Office Address)
____________________________ _____________________________ (Years in Title Industry) (Office Phone Number)
This Nominee should receive the MLTA Executive of the Year Award for the following reasons (attach additional sheet if necessary):
Nominated by: Phone:
(Please sign the nomination to confirm MLTA membership. Nomination information will be held in confidence.)
Signature:________________________________________________________________
Return this Nomination Form in the enclosed envelope by July 20th to:
MLTA Office
Attn: Russ Gowen
P.O. Box 6322
Helena , MT 59604
Fax 406-442-8018