Roberta Zurn Outstanding Women in Leadership Award - Nomination Form
The Roberta Zurn Award, named after local philanthropist Roberta Zurn, is awarded annually to a woman in our community who has encouraged the advancement and full participation of women and girls in society.
Deadline: November 15
Please note: Nominations will be kept on file for three years. Nominators from previous years will be contacted to determine whether they’d like their nomination to be considered for current award year. Updates to the application are encouraged.
Nominator information
That's you!
Your Name
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First Name
Last Name
Your Phone Number
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Area Code
Phone Number
Your E-mail
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Nominee Information
Tell us about the woman you believe deserves to be recognized!
Her Name
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First Name
Last Name
Her E-mail
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Her Phone Number
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Area Code
Phone Number
Her Business or Affiliation
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Where does she work or volunteer
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Nomination Questions
Please be detailed, specific, and cite examples.
How has the candidate fostered an impact on the attitudes and actions that benefit women and/or girls?
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Word limit: 500
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How has the candidate encouraged women and/or girls to develop as philanthropists or promoted self-sufficiency?
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Word limit: 500
0/500
How has the candidate served as a role model and/or mentor to women in the community?
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Word limit: 500
0/500
How has the candidate exhibited and demonstrated qualities of leadership, integrity, dedication, and motivation?
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Word limit: 500
If the candidate's job duties are covered as part of this nomination please provide specific examples of how they went above and beyond requirements of the role to earn this nomination. If this does not apply, type "N/A."
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Word limit: 500
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Supporting documentation
Please include any documentation that supports your nomination such as photos, event information, newspaper articles, etc.
Upload the first LABELED file.
Please label the file with the identifying information (i.e. JANESMITH_RESUME.pdf).
Upload an additional LABELED file, if needed.
Please label the file with the identifying information (i.e. JANESMITH_PHOTO.jpg).
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