CryptoVixens Women in Technology Awards Nomination Form

CryptoVixens Women in Technology Awards Nomination

Please fill out this form to nominate your favorite female founder or developer for an award.
1. Choose the Award
Choose the award

ENTREPRENEUR AWARDDATA SCIENTIST AWARDTRAILBLAZER AWARDDIGITAL TRANSFORMATION AWARDBLOCKCHAIN AWARDFINTECH AWARDIT BUSINESS LEADERRISING STAR AWARDSECURITY LEADER AWARDDISRUPTOR AWARDMENTORSHIP AWARDCRYPTOVIXENS IMPACT AWARDOther
2. Nominee Information
Reason For Nomination
Nominee's Name

First NameLast Name
Nominee's E-mail Address
Nominee's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Is Nominee Attending SXSW 2019? (preference given to women who can attend awards).

YesNoI Don't Know
3. Your Information
Your Name

First NameLast Name
Your E-mail
Your Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Should be Empty: