Nominate A Candidate

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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. Online program applications will be available from May 15 - June 16, 2017. All applications must be submitted by midnight on June 16th to be considered for the program. 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: * 2017-2018
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: *
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