Nominate a Leadership Polk Candidate
We appreciate your help in identifying strong candidates for Leadership Polk Class XX (20). The nomination deadline is Friday, February 27, 2025.
Nominator Information:
Your Name
*
First Name
Last Name
Your Preferred Email
*
example@example.com
Your Preferred Phone Number
*
Please enter a valid phone number.
Your Employer & Job Title
Relationship to Nominee
*
Employer/Sponsoring Organization
Colleague
Family/Friend
Self
Are you a Leadership Polk Alumni?
*
Yes
No
Is the Nominee aware that you are submitting this nomination?
*
Yes
Not yet, but I plan to contact them ASAP
No, I would like my nomination to remain anonymous
N/A, self-nomination
Who Are You Nominating for Leadership Polk?
(Self-nominations can keep this section blank)
Nominee's Name
First Name
Last Name
Nominee's Preferred Email
example@example.com
Nominee's Preferred Phone Number
Please enter a valid phone number.
Nominee's Home or Work City
Nominee's Employer & Job Title
Has this Nominee completed a City or State leadership program? If so, which one?
*
Leadership Bartow
Leadership Fort Meade
Northeast Polk Leadership
Leadership Lakeland
Leadership Lake Wales
Leadership Winter Haven
Leadership Florida
Inside Polk County Public Schools (Inside PCPS)
Public Service Leadership Course
Other
Not Sure
Submit
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