ATHENA Award Nomination Form

Apr 28, 2015 - Other Memberships, Achievements, Awards and Publications (Accolades) - Nominees may already have been honored for service to their ...
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ATHENA Award Nomination Form Save the date for the ATHENA Awards Ceremony on April 28, 2015 at the Broadmoor Call Krista Herring at 719-636-5073 x124 for Sponsorships and Corporate Tables Each year, the ATHENA Award is given to an outstanding female businesswoman that has helped engage others in the community and become a mentor for one or more individuals. Nominee Name: _________________________________________________________________________ Company: ______________________________________________________________________________ Business Address: ________________________________________________________________________ City: ________________________________________ State: ____________ Zip Code: ________________ Phone: _________________________ Email: __________________________________________________ Nominator Name: ______________________________________ Phone: ___________________________ Address: _______________________________________________________________________________ To the best of your ability, please describe and provide examples of the attributes and accomplishments of your nominee in the following areas: Mentorship—Provide specific examples of how the nominee has demonstrated support for the advancement and leadership development of business and professional women. (NOTE: Please provide names of women assisted/mentored if permission is granted for names to be released; if not please note) Business & Accomplishment—List special recognitions, projects and achievements; include business-related affiliations, directorships, trusteeships or other designations. Community Service—Describe local, county and state level participation. Include length of service and office held in civic service organizations, charitable activities, political pursuits, religious groups, chambers of commerce, merchants associations, etc. Other Memberships, Achievements, Awards and Publications (Accolades) - Nominees may already have been honored for service to their profession, industry or community. They also may have publications to their credit published supporting their service to their profession, industry or community. Please list awards and honors received which support this nomination. Please make sure the following is included; see next page for fillable boxes on the above criteria. You may include a letter of recommendation for your nominee—Please do not send more than 2 letters One Digital Photo Requested Included Link to Nominee’s LinkedIn Profile _________________________________________________________

Mentorship: (Max: 500 words) -

Business Accomplishment: (Max: 500 words) -

Community Service & Other Accolades: (Max: 600 words) -

ADDITIONAL INFORMATION PERTAINING TO CRITERIA: IF SUBMITTING VIA EMAIL, PLEASE DO NOT INCLUDE INFORMATION YOU WOULD LIKE TO BE CONSIDERED IN THE SELECTION PROCESS IN THE EMAIL ITSELF, ONLY IN ATTACHMENTS. Friday, February 27, 2015 by 5:00 p.m. to: 25 N. Wahsatch Ave. Ste. 100 | Colorado Springs, CO 80903 Phone 719-636-5076 | Fax 719-636-1956 -636-5076 x124 [email protected]