2024 MADA TIME Dealer of the Year Nomination Form Thank you for your interest in nominating the MADA 2024 TIME Dealer of the Year. Nominees are presented to the MADA Board of Directors and are voted on by secret ballot. Please complete the information below for formal submission. Name of Nominee First NameLast Name Dealership Name E-mail of the Nominee Phone of the Nominee Address of the Nominee Street Address Street Address Line 2 CityState / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Nagorno-Karabakh Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Turkish Republic of Northern Cyprus Northern Mariana Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Republic of the Congo Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia South Sudan Spain Sri Lanka Sudan Suriname Svalbard eSwatini Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Transnistria Pridnestrovie Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands Isle of Man US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Name of the person making the nomination. Email of the person making the nomination. example@example.com Below are the nomination requirements established by the award presenters. Each question must be answered in the affirmative for the nominee to qualify. Nominee is a franchised new-car dealer* YesNo Nominee is a member of the NADA* YesNo Nominee is a member of a state dealer association* YesNo Nominee is the actual operating head of the dealership as designated in the franchise paragraph of the factory agreement, or the owner’s designated agent with full authority for business operations for a minimum of one year with recognition by the sponsoring dealer association as the dealership's voting representative* YesNo Nominee has an ongoing presence in the dealership offices, actively managingthe dealership* YesNo Nominee has at least a five-year record of active participation in affairs of the nominee’s state dealer association* YesNo Nominee agrees to be available for participation in Dealer of the Year activityduring the year following selection* YesNo If answered yes to all the questions above, the following information will be submitted to the Board of Directors for consideration: List nominee’s positions currently held or past participation with the Mississippi Automobile Dealers Association. List nominee’s service to community and humanity. List nominee’s civic, political and educational activities. List nominee’s additional contributions to benefit others. Phone Number -Area CodePhone Number Apply Should be Empty: Now create your own Jotform - It's free! Create your own Jotform
