Insight on Philanthropy – Executive Excellence – Nominate

Nomination Form

Nominee Information

Is this a self-nomination?(Required)

Yes

Full Name of Nominee(Required)

First Last

Nominee’s county of residence

Nominee’s Job Title:(Required)

Nominee’s Organization Name(Required)

Organization Website

How long has the nominee been employed with their current organization(Required)

Nominee’s Email(Required)

Nominee’s Phone Number(Required)

Link to nominee’s bio and/or LinkedIn page

Reason for Nomination

Please list civic and/or nonprofit organizations with which the nominee is involved. List multiple by clearly indicating which roles the nominee served in for each.(Required)

Why should this leader be recognized? Describe their impact on the regional economy, innovation, community leadership and/or business growth.(Required)

What are their key accomplishments? Include recent achievements, awards, milestones or initiatives to which they've contributed. (Required)

I'd like to submit my nomination for the following: (Check all that apply.)

Executive Excellence: Who's who of Northeast Wisconsin business

Women of Influence: Female professionals shaping industries and communities

40 Under 40: Next-generation leaders under age 40

Power Book: The region’s most notable leaders by industry

Nominator Information

Tell us about yourself.

Name(Required)

First Last

Relationship to Nominee

Email(Required)

Phone(Required)

Would you like to stay anonymous?