APPLICATION DEADLINE: July 22, 2019

All supporting materials (headshot, résumé, any supporting credentials, etc.) must also be emailed to 40under40@grbj.com by July 22, 2019.

Nominees must be under 40 years of age as of 10/29/19.

**For this reason, it is paramount that the actual nominee completes and submits all information on this page, directly.**

For questions, please contact GRBJ Editor Tim Gortsema at tgortsema@grbj.com.


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NOTE:
IF YOU ARE ATTEMPTING TO NOMINATE A 3RD PARTY, NOMINATE HERE: http://bit.ly/2XGjOe4.
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* 1. Contact information:

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* 2. Age:

Date of birth:

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* 3. More about the nominee:

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* 4. Awards/Accomplishments/Honors:

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* 5. PROFESSIONAL board/council memberships:

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* 6. COMMUNITY board/council memberships:

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* 7. Other volunteer activities:

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* 8. Who is the biggest influence in your life?

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* 9. What was your biggest professional break?

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* 10. What professional accomplishment are you most proud of?

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* 11. Why do you believe that you should be included in GRBJ's 2019 40 Under 40 class?

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