2024 Sharing Success Awards

IMPACT - Individual/Organization Award

NOMINATION FORM
Presented to an individual or organization who/which, through dedication and determination, led the way to unprecedented or significant business opportunities for minority businesses with their industry.

The deadline for submission is December 15, 2024.
SECTION 1: NOMINATOR INFORMATION
NAME*
TITLE*
COMPANY*
COMPANY ADDRESS*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.
Nominator Email*
example@example.com
SECTION 2: NOMINEE INFORMATION

(Please Provide Below Your Nomination)
NAME*
TITLE*
COMPANY
COMPANY ADDRESS*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.
Nominee Email*
example@example.com
SECTION 3: REASON(S) FOR NOMINATION
Please provide a reason for the nomination:*
If you have any documentation to support your nomination please upload here (optional):

Cancelof
Should be Empty:

IMPACT - Individual/Organization Award