Questions on Nomination Form

Here is a preview of the questions you'll encounter on the nominatIon form.

Nominator Info

Address (work or home), City, State, Zip
Phone Number


Nominee Info

Name of Individual You Are Nominating
Nominee's City of Residence
Nominee's Phone Number (work or home)  
Nominee's Email (work or home)
Nominee's Date of Birth (mo/dy/year) Must be under the age of 40 on May 29, 2020  
Has the nominee lived in the Michiana region for a minimum of two years? Yes or No
Nominee's Current Job Title/Position
Nominee's Current Employer 
Nominee's Employer Address, City, State, Zip
List any colleges attended, degrees earned by the nominee
List/describe the nominee's business accomplishments (job responsibilities, results, special projects, business-related affiliations)
List/describe the nominee's community involvement (civic, charitable and/or religious involvement)
List the nominee's special achievements, awards & special recognition        
Nominee's family (spouse, children, if applicable)     
Additional Comments (Remember to "Sell" the Nominee)