Welcome to the online nomination form for the 2013 Small Business Day Eagle Awards. Use this form to nominate a business or individual in Knox, Warren, Mercer or Henderson counties for their entrepreneurial achievement.

If you prefer, you can call 309-342-5108 to have a nomination form mailed to you, or you can pick it up at the following address. After completing the form, mail it back to: University of Illinois Extension, 180 S. Soangetaha Rd., Suite 108, Galesburg, IL 61401. The completed form must be received by April 1, 2013.

Note: You may choose to nominate a business / individual for more than one category. In that case, you need only to select which categories and complete this form once. If nominating multiple businesses / individuals, you will need to complete this entire form again, for each of them. Please note the next button at the bottom of each page; there are 7 pages to complete.

ESN may choose not to accept any nomination that is not completed or ones that lack the contact information of the nominee.

If you have any questions or difficulty using this form, contact Ryan Lilly at or 309-371-0473 .

ALL NOMINATIONS MUST BE IN BY APRIL 1, 2013. Winners will be announced at the Small Business Day Luncheon on May 14, 2013 at Lake Storey Pavilion in Galesburg, Illinois.

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