40 Leaders Alumnus of the Year Nomination Form

40 Leaders Under FortyThe fourth annual 40 Leaders Alumnus of the Year award will be presented to a previous award recipient who has continued to make an impact on the central Illinois community.

Nominations are due by 5pm on Friday, June 9, 2017. You must be a previous recipient of the 40 Leaders Under Forty award to submit a nomination.

The 2017 40 Leaders Alumnus of the Year will be revealed at the 40 Leaders Alumni Social at Dozer Park on Thursday, July 27, 2017.

View the complete list of 40 Leaders alumni...

About the Nominator
Nominator's name
Email address of nominator
Year you received the 40 Leaders Under Forty Award
About the Nominee
Nominee's name
Email address of nominee
Year nominee received the 40 Leaders Under Forty Award
Nominee's company or organization
Nominee's career accomplishments
Nominee's involvement with nonprofits, charities and community organizations
Any additional information you would like to include in your nomination.