Nominator Name

      Nominator Organization

      Nominator Email

      Nominator Phone (in case there is a question concerning the nominee)



      Nominee Name

      Nominee Email

      Nominee Phone

      Nominee Organization

      Nominee Title/Position at work

      Nominee City

      How long have you known the nominee?

      Why are they a strong candidate for the NextGen Leaders Program?

      Are there any special considerations you’d like us to know about the nominee?