Roberta Zurn Outstanding Women in Leadership Award - 2022 Nomination Form
The Roberta Zurn Award, named after local philanthropist Roberta Zurn, is awarded annually to a woman in our community who has made outstanding contributions toward improving the status of women and girls in our community.
Deadline: November 30
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.
In general, describe how the candidate demonstrates leadership qualities, integrity, dedication and motivation through her volunteer and/or career experiences.
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Specifically, how does the candidate positively impact the attitudes and actions that benefit women and girls?*
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See below for further direction.
*Consider examples that demonstrate one or many of the following:
The candidate's impact or leadership in the community as a whole, in the workplace, or in volunteer activities
How the candidate has encouraged women/girls to develop as philanthropists or become self-sufficient
How the candidate has served as a role model and/or mentor
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Supporting documentation
Please provide any additional information that supports this nomination. Examples include stories of impact, testimonials, references and news clippings
Would you like to provide any additional information?
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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