|
Nominee Information |
| Full Name: |
|
| Company Name: |
|
| Company Address: |
|
| City, State ZIP: |
,
|
| Fax: |
|
| Telephone number: |
|
| Email: |
|
| |
| What category do you nominate this person for? |
| |
Small Business (under 100 employees) |
| |
Large Business |
| |
Non-profit Organization |
| |
Government/Economic Development |
| |
| In your opinion, how does the nominee best display “entrepreneurial spirit?” |
|
|
| |
| In your opinion, what makes the nominee exceptional in personal and/or professional life, including community involvement? |
|
|
| |
| In your opinion, how has the nominee improved the business climate or contributed to economic growth in the last year? |
|
|
| |
| Please list at least three individuals who can serve as business references for the nominee. These may include bankers, lawyers, financial consultants, accountants, vendors, customers, or other business professionals. |
| #1 |
|
| Name: |
|
| Company: |
|
| Phone number: |
|
| Relationship to nominee: |
|
| #2 |
|
| Name: |
|
| Company: |
|
| Phone number: |
|
| Relationship to nominee: |
|
| #3 |
|
| Name: |
|
| Company: |
|
| Phone number: |
|
| Relationship to nominee: |
|
About the nominator:
(if other than nominee) |
|
Name:
|
|
| Company: |
|
| Phone number: |
|
| Email: |
|
| Relationship to the nominee: |
|
| |
|