2017 Rising Stars Nomination Form Nominee Name * Nominee Title * Nominee Company * Address * Phone Number * Email * Date of Birth * Age * Nominator Name * Nominator Title * Nominator Company * Phone Number * Email * What makes this nominee an outstanding candidate for this award? Please include professional and entrepreneurial accomplishments as well as demonstrated leadership qualities. * What differentiates the nominee from other colleagues in his or her profession? * What strengths does the nominee have that has most contributed to his or her success? * What professional impact would the nominee like to make in the next 10 years. What does the nominee want his or her legacy to be? * Please Copy & Paste Nominee's Resume or CV here. * If you are human, leave this field blank.