Nomination Form

NOMINEE. Electronically complete, save, and email the form to Barbara Oliver at ... List specific achievements and contributions within the business/industry. 4.
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NOMINEE FORM MY WBEs/MBEs WHO ROCK! NOMINEE

CHANGING THE FACE OF ENTREPRENEURSHIP

Electronically complete, save, and email the form to Barbara Oliver at [email protected] You can also print the form, fill out, and fax it to (310) 294-3780. If you have any questions, please call Barbara at (310) 294-3780 ext. 5.

I am nominating a candidate for:

□ WBEs Who Rock!



MBEs Who Rock!

Nominee Information Nominee’s Name:___________________________________________________________________________________ Company:_________________________________________________________________________________________ Title:_________________________________________________ Years in Role with Company:____________________ Work Phone:____________________________________ Cell Phone:_________________________________________ Email:_________________________________________ Company Website:___________________________________

Nominator Information: Nominator’s Name:_________________________________________________________________________________ Company:_________________________________________________________________________________________ Title:_____________________________________________________________________________________________ Work Phone:____________________________________ Cell Phone:_________________________________________ Email:____________________________________________________________________________________________

My nominee knows s/he is being nominated:

□ Yes □

No

How I know the nominee:________________________________________________________________________________



This is a self-nomination.

Enterprise Publishing Inc. 2726 Manteno Court Henderson, NV 89052 Barbara Oliver [email protected] work: (310) 294-3780 ext. 5 fax: (310) 294-3780

www.mbemag.com

NOMINEE FORM MY WBEs/MBEs WHO ROCK! NOMINEE

CHANGING THE FACE OF ENTREPRENEURSHIP

Why I Am Nominating this Individual 1. List specific achievements within, and contributions to, the community (local, regional, national).

2. List involvement in various causes, such as environmental, civil rights, community, etc.

Enterprise Publishing Inc. 2726 Manteno Court Henderson, NV 89052 Barbara Oliver [email protected] work: (310) 294-3780 ext. 5 fax: (310) 294-3780

www.mbemag.com

NOMINEE FORM MY WBEs/MBEs WHO ROCK! NOMINEE

CHANGING THE FACE OF ENTREPRENEURSHIP

Why I Am Nominating this Individual (Continued…) 3. List specific achievements and contributions within the business/industry.

4. Why do you think this person deserves this award? Provide any history or examples of empowering and/or inspiring others. (No more than 250–300 words)

Enterprise Publishing Inc. 2726 Manteno Court Henderson, NV 89052 Barbara Oliver [email protected] work: (310) 294-3780 ext. 5 fax: (310) 294-3780

www.mbemag.com