Clone of 70 Over Seventy Awards Nomination Form

Nominees must be 70 years of age or older to be eligible for consideration.

Nominations may be submitted in as many categories as you wish. However, each submission requires a separate nomination form and individuals can only be honored in one category.

For a complete description of each award category, please see website.

Please note: The deadline for nominations is July 1, 2026.
70 over seventy Awards Nomination form - class of 2026
Referred by: (optional)

First NameLast Name
- Nominee's Name
  
  First NameLast Name
- Nominee's Phone Number
  
  Area CodePhone Number
- Nominee's E-mail Address
- Nominee's Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Please provide a brief narrative to support your nomination (no more than 500 words per question). Your nomination should include:
  - Why you are nominating this individual for this specific category;
  - How they have made or continue to make an impact in their field or the community;
  - How they have shown that impact is not limited by age.
- Nominee Overview (Can include work and/or accomplishments at any age)
  
  0/500
- Choose the Award
- Are there any special accomplishments or work since turning 70? (If no, please enter N/A)
  
  0/500
- Your Name
  
  First NameLast Name
- Your E-mail Address
- Your Phone Number
  
  Area CodePhone Number
- Your Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Should be Empty:

70 over seventy Awards Nomination form - class of 2026