Section 1: Nominee Information

Only form fields marked with a * are required. All other information is not required.
Fill out as much as possible.

Section 2: Nominator Information

Section III: Biographical Profile

The judges will concentrate on three areas with particular emphasis on recent accomplishments.

Nominations must include information from all three categories below, using all headings as illustrated, in a narrative format. Under each heading we have included a sample outline to help you begin the process.

I. PROFESSIONAL ACCOMPLISHMENTS

This is the individual’s level of achievement within her company, industry and economic region. Examples may include but are not limited to:

• A description of the nominee's most signifigant professional accomplishments
• Organization where nominee works and has worked, important dates, titles, and responsibilities
• Licenses, degrees, areas of professional expertise
• Honors and awards
• Special skils and abilities

In the box below, please indicate your nomination's PROFESSIONAL ACCOMPLISHMENTS:

II. COMMUNITY INVOLVEMENT

List past and present community involvement activities in which the nominee and/or her business is or has been involved and describe the extent of the involvement. Examples may include but are not limited to:

• Honors and awards received (list dates, nature of award, etc.)
• Past and/or present active involvement in community organizations where the nominee has made a signifigant difference. Explain the nature of involvement and list dates ov involvement, contact person, and phone number.

In the box below, please indicate your nomination's COMMUNITY INVOLVEMENT:

III. ADVOCACY FOR WOMEN

Demonstrate individual’s impact and success within her company, industry and economic region as it relates to but is not limited to:

• Supporting personal or professional growth
• Roles in decision-making and extent of these roles
• Demonstration of positive growth trends, programs, products/services, profits
• Overcoming professional obstacles

In the box below, please indicate your nomination's ADVOCACY FOR WOMEN:

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