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?