Nominate A Candidate

INSTRUCTIONS: To be considered for the class, participants must be nominated and complete an application form. Nominations are accepted year-round, but must be received by May 1st to be eligible for the next year's class. Self nominations are encouraged. Program applications on-line from May 3rd to June 18th and must be finished by midnight on June 18th. A selection committee, comprised of Leadership Iowa alumni and ABI representatives will review, rate and select the individuals for the next class year. Individuals are notified of their acceptance in early August.

To nominate yourself, complete this form.

Complete the following form and submit for processing. If you have questions, please contact kthomas@iowaabi.org at 515-235-0564.

* denotes required field
Nominee Information

First Name: *
Last Name: *
Job Title: *
Company / Organization: *
Street Address 1: *
Street Address 2:
City: *
State / Zip Code: *	/
Phone Number: *	xxx-xxx-xxxx
Work E-mail: *
Nomination Year: *	2011-2012
Comments:
Nominator Information

First Name: *
Last Name: *
Job Title: *
Company / Organization: *
Street Address 1: *
Street Address 2:
City: *
State / Zip Code: *	/
Phone Number: *	xxx-xxx-xxxx
E-mail: *

Nominate A Candidate

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