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Nominate a Leader!

The Greater Peoria Area is blessed with many active, young business professionals, entrepreneurs and community volunteers. Please help us select a new group of young leaders to honor as our 2010 class of 40 Leaders Under Forty.

Please submit the following information by 5:00pm, Wednesday, September 15, 2010. Late nominations will not be considered.

WARNING: To avoid accidentally losing your information, type into a word processing application first, then copy and paste into the fields below.

If you prefer to print and mail the nomination form, download the nomination form in PDF format!

 

About the Nominator
Nominator's full name
Nominator's company or organization
Nominator's address
Nominator's phone
Nominator's fax number
Nominator's email address
Nominee Information
Nominee's full name
Nominee's birthdate
Nominee's company/organization
(25 words or less)
Nominee's job title and duties
Nominee's business address
Nominee's business phone
Nominee's home address
Nominee's home phone
Nominee's fax number
Nominee's email address
Additional Information
(Work-related endeavors required by the employer may receive a lower score.)