Tina Ross Business Leadership Award Application Nominee Information First Name Last Name Present Position/Title Address for Nominee Address Line 1 Address Line 2 City State Select option... Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming DC Zip/Postal Code Nominator Inrformation First Name Last Name Contact Information 1. Who do you want to recognize as a business leader and community leader locally? and WHY? 2. Please describe the nominee’s business accomplishments, such as demonstration of management or product innovation. 3. Please describe the nominee’s leadership role in the business sector and any personal characteristics emphasizing integrity and fair business practices. 4. Please list any professional, community and civic involvement.
