Survey - 2023 Leader Luncheon Nomination Form

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2023 Leader Luncheon Nomination Form

1. Field Is Required Nomination Category

Arts
Business & Professions
Communication & Technology
Education
Public Service
Racial Justice
Social Service
Volunteer & Community Service

2. Field Is Required Nominee's Full Name (as the nominee wishes it to appear in print)

3. Preferred Pronouns

she/her/her's
they/them/theirs

4. Field Is Required Home Address/City/State/Zip: (Maximum response 255 chars, approx. 5 rows of text)

5. Field Is Required Phone Number:

6. Field Is Required Email:

7. Field Is Required Nominee's Occupation/Profession (employed or volunteer): (Maximum response 255 chars, approx. 5 rows of text)

8. Field Is Required Name of Nominator (as you would like it to appear in print)

9. Contact Name (if nominator was a company):

10. Field Is Required Address/City/State/Zip:

11. Field Is Required Phone Number:

12. Field Is Required Email:

Narrative Directions: Please respond briefly to the following statements.

13. Field Is Required Describe how you have known or worked with the nominee.

14. Field Is Required List the significant achievements of the nominee in the named category.

15. Field Is Required List past or present positions of leadership or responsibility.

16. Field Is Required Describe qualities of leadership demonstrated by the nominee.

17. Field Is Required Describe how this person has demonstrated a commitment to excellence.

18. Field Is Required Explain how the nominee made an outstanding or innovative contribution in their category.

19. Field Is Required In 70 words or less, provide important accomplishments that support your nominee being chosen as the 2023 award recipient in their category. This will be used on the website and at the event.

Nominee Portrait

In order for this nomination to be considered complete, the nominee portraits must be emailed to info@ywcaelgin.org by the March 2nd deadline. In the subject line of your email please indicate that it is a Leader Luncheon Nominee Portrait and include the name of the nominee.

Spam Control Text: Please leave this field empty

220 East Chicago St., Elgin, IL 60120 | Phone: (847) 742-7930 | Fax: (847) 742-8217 | info@ywcaelgin.org