Women Making a Difference
Nomination Form

The Women in Business Committee is looking for Unsung Heroes to be honored at the General Membership Luncheon, March 10th, 2010. Do you have a female employee or know of a female small business owner who has made a difference in your corporate environment or in the community and has not received recognition? If so please fill out the nomination form below, so we can honor your Unsung Hero. Please Note: Nomination deadline is February 24, 2010. [Printable Version] * indicates required Name of Nominee: *
Company: *
Mailing Address: *
City: *	State: *	Zip Code: *
Business Phone: * (e.g. 999-999-9999)	Fax: (e.g. 999-999-9999)
Email Address: *
Person Making Nomination Your Name: *
Company: *
Mailing Address: *
City: *	State: *	Zip Code: *
Business Phone: * (e.g. 999-999-9999)	Fax: (e.g. 999-999-9999)
Email Address: *
Please explain in 200 words or less why this person should be nominated.

Women Making a DifferenceNomination Form