Nominate a Candidate for Leadership Polk Class XX

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 NameLast 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 OrganizationColleagueFamily/FriendSelf
Are you a Leadership Polk Alumni?*

YesNo
Is the Nominee aware that you are submitting this nomination?*

YesNot yet, but I plan to contact them ASAPNo, I would like my nomination to remain anonymousN/A, self-nomination
Who Are You Nominating for Leadership Polk?

(Self-nominations can keep this section blank)
Nominee's Name

First NameLast 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 BartowLeadership Fort MeadeNortheast Polk LeadershipLeadership LakelandLeadership Lake WalesLeadership Winter HavenLeadership FloridaInside Polk County Public Schools (Inside PCPS)Public Service Leadership CourseOtherNot Sure
Should be Empty:

Nominate a Leadership Polk Candidate