Broker Nomination for Yuma B.U.I.L.T. 2027

Broker Nomination for Yuma B.U.I.L.T. 2027

Submit your broker and nominee details, confirm expectations, and provide your typed signature before the October 30, 2026 deadline.
Tentative 2027 program schedule — all dates are subject to confirmation:
- February 17 — Know Yourself, Know Your Purpose
- March 17 — Industry, Agriculture & Infrastructure
- April 21 — Community, Government & Healthcare
- May 19 — Leading in Uniform & in Service
- June 16 — Association & State Leadership
- July 14 - Graduation at Association Luncheon
Broker/Nominator Full Name

First NameLast Name
Broker Email
example@example.com
Broker Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Brokerage / Company
Nominee Name

First NameLast Name
Nominee Email
example@example.com
Nominee Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Nominee Company / Current Role
How long have you (the broker) known the nominee?
Why should this nominee be considered? Please include examples of leadership potential, integrity, coachability, and community or professional service.
Do you (the broker) support the nominee’s attendance at all five program sessions?
Do you acknowledge that nomination does not guarantee acceptance?
Do you understand that the nominee must submit a separate individual application and complete all commitments?
Typed Signature (Broker)
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: