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Lifetime Achievement Award


Deadline Extended: Oct. 1, 2020

Complete this form to apply for the Lifetime Achievement Award.

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

Nominee Contact Information
Full Name

Company

Job Title

Street Address

City

State

ZIP

Email Address

Phone Number

 

Company Information
Date Founded

Company Description

Number of Employees

Website

Nominee Qualifications
Length of Time at Company

Length of Time in Current Position


How has the nominee contributed to the company's growth, innovation and profitability over the course of his/her career? (Please provide examples and quantitative data as support.)


How has the nominee demonstrated leadership within the organization over the course of his/her career?


Describe the nominee's career history and significant achievements.


Why should this person be honored with a Lifetime Achievement Award?

Nominated By
Full Name

Company

Title

Email Address

Phone Number

 

 

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