Nominations

Your Info

Nominator's Name:

Nominator's Phone:

Nominator's Email:

Nominee's Info

Name of Nominee:

Birth Date:
Nominees must be 39 or younger as of December 31, 2021.
mm/dd/yy

Employer:

Job Title:

Work Phone:

Work Email:

Responses

Career achievement (20 points):

Commitment to excellence in career (10 points):

Leadership within company and/or industry (10 points):

Commitment to business growth (10 points):

Involvement in community activities (20 points):

Leadership in community organizations (10 points):

Files

Limit: 5mb per file and PDF, DOC, or DOCX format

Nominee's Resumé:

Letter:

*Please note that all fields are required to submit a nomination.

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