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Please complete this form to the best of your ability. Personal testimonies and documented examples of leadership techniques and experiences are necessary and considered an important part of the nomination process. Please include them! Short stories, examples, testimonials...these all provide valuable context to the nomination!

THE ATHENA Young Professional AWARD

ATHENA Young Professional Leadership nominees are emerging leaders who meet each of the following criteria:

1. Demonstrates excellence, creativity, and initiative in their business or profession

2. Provides valuable service to improve the quality of life for others in their community

3. Clearly serves as a role model for young women, both personally and professionally

4. ATHENA Young Professionals are 40 or younger

5. ATHENA Young Professionals may represent either the for-profit or non-profit sector

* Nominee Name: enter the name of the individual you would like to nominate for the ATHENA Young Professional Award.
0/250
* Nominee Company & Title: enter the nominee's employer/company name & job title.
0/250
* Nominee Address: enter the nominee's address.
0/250
* Nominee Phone & Email: enter the nominee's phone number and email address.
0/250
* Nominator: enter the name of the person(s) completing this form.
0/250
* Nominator: enter the telephone number and email of the person(s) completing this form.
0/250
* Date of submission: enter today's date.
0/50
* Professional Leadership: provide specific examples of how the nominee is an emerging leader in their life's work.
0/500
* Community Leadership: provide examples of how the nominee provides valuable service to improve the quality of life for others in the community. Include type and length of service in civic and service organizations and initiatives.
0/500
* Personal Leadership: provide specific examples of how the nominee serves as a role model for young women, both personally and professionally.
0/500
* Additional information: include any additional information you feel is important for consideration of your nominee. Include awards, honors, publications, articles, and/or testimonials that demonstrate service to their profession, community, and aspiring women leaders.
0/500

If you need to submit additional documentation, please email all documents to: nichole@mibarry.com.

Up to 5 additional supporting documents may be included with your nomination form.