Bookmark and Share Email this page Email Print this page Print Pin It


General Application

Deadline Extended: Oct. 1, 2020

Complete this form to apply for any of the following categories:

  • Small Company - 50 or fewer employees
  • Medium Company - 51-200 employees
  • Large Company - more than 200 employees
  • Start-Up Company - in business for no more than five years
  • Family Business - serving in a role at his or her family's company; may also be related by marriage
  • Executive of the Year - open only to the top-level executive at an organization; all qualifying applications will be considered for this award with the exception of the Lifetime Achievement Award

Please note that all fields are mandatory. If you have any questions, please email

Award Category (select one):

Nominee Contact Information
Full Name


Job Title

Street Address




Email Address

Phone Number

Company Information
Date Founded

Company Description

Number of Employees


Nominee Qualifications
Length of Time at Company

Length of Time in Current Position

Is this person the top executive at the company?
Yes No

Over the last 12 months, how has the nominee contributed to the company's growth, innovation and profitability? (Please provide examples and quantitative data as support.)

How has the nominee demonstrated leadership within the organization in the last 12 months?

Describe the nominee's significant achievements in the last 12 months.

Why should this person be considered an Executive of the Year?

Nominated By
Full Name



Email Address

Phone Number



Edit ModuleEdit Module

RSS Subscribe

Edit Module