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To nominate someone for a Business Leadership Award, complete the form below. Please read about the nomination criteria before you begin. Nominations are due by Monday, December 7, 2009.

An asterisk (*) indicates a required field.

Part 1. Nominator Information

Tell us about yourself.

Title:* Dr. Mr. Mrs. Ms.
First Name:*
Middle Name:
Last Name:*
Address 1:
Address 2:
City:
State:
Zip Code: [ ##### or #####-#### ]
Phone:* [ ###-###-#### ]
E-Mail:* [ username@domain.foo ]

Part 2. Nominee Information

Tell us about the business leader whom you are nominating.

Title:* Dr. Mr. Mrs. Ms.
First Name:*
Middle Name:
Last Name:*
Job Title:*
Business Name:*
Employees:* <= 50 > 50
Address 1:*
Address 2:
City:*
State:*
Zip Code:* [ ##### or #####-#### ]
Phone:* [ ###-###-#### ]
E-Mail:* [ username@domain.foo ]

Part 3. Nomination Information

Category:* Business Leader of the Year ( > 50 employees )
Small Business Leader of the Year ( <= 50 employees )
Non-Profit Business Leader of the Year
Letter:* Award decisions are based heavily on the details you provide in a nomination letter. Please tell us about this person and why you feel he/she is deserving of a nomination. Type (or paste from another document) the text of your nomination letter below:

2500 characters minimum.    You have entered: characters.

Part 4. Finish

Please take a moment to review what you have entered, then press the Submit button below.