Jersey's Best Nomination Form 2023

NOMINEE INFORMATION

questions? email info@njadclub.org
Nominee Name*

First NameLast Name
Nominee Title*
Nominee Email*
example@example.com
Nominee Phone Number*

Area CodePhone Number
Nominee Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birthday (The Nominee must be 40 or younger on April 1st, 2023)

MonthDayYear
Date
What special skills, abilities, insights make this nominee stand out?
How has the nominee been an exemplary leader? How have they shown creativity, motivated others, overcome challenges, promoted excellence and innovation, or bettered their environment.
How has the nominee inspired others, grown their business or helped others achieve their vision?
Has the nominee earned any other award for marketing or advertising in the past? i.e. Jersey Award
Please Submit A Short Bio Of The Nominee:
NOMINATOR INFORMATION
Nominator Name*
Nominator Company*
Nominator Title*
Nominator E-mail*
Nominator Phone Number:*

Area CodePhone Number
Please attach a headshot of nominee if available. (The headshot will be used for the event program in April)*

Browse Files
We accept *.jpg files only Cancelof

Nomination Payment

Nomination Fee$40.00

Click here to add $40.00 fee. All transactions will be completed by Stripe.

Total $0.00

By clicking the "Submit Application" button you are submiting your online application.

Thank you!
Should be Empty:

NOMINEE INFORMATION