NOMINATION FORM

The Phyllis Goldman Encouragement Award is given in honor and memory of Phyllis Goldman, a local businesswoman. Phyllis inspired women to stretch themselves beyond society’s norms and expectations by following their dreams and hearts as they pursue a career and redirected their life paths.
 
This award recognizes women in our community who have demonstrated noteworthy entrepreneurial and professional pursuits, who are committed to community and have served as a role model for other women and girls pursuing their career dreams. The award, presented at the Chamber Awards Luncheon (May 3, 2018), recognizes a woman who owns a business (or is a majority owner) and has demonstrated a noteworthy entrepreneurial pursuit. Nominees are owners in for-profit businesses (within the last seven years) who inspire and mentor other women to do the same.
 
To be considered, the nominee:

♦          has acted as a role model for women and girls pursuing their career dreams
♦          and has demonstrated significant entrepreneurial leadership in a for-profit business.
♦          Her business has demonstrated “staying power” and positive response to adversity in a changing business environment.
♦          Her business has demonstrated community involvement and commitment to women-related community projects.
♦          Must be living at the time of nomination.
♦          Nominees need not be Chamber members; directors of non-profits are not eligible.
 
Nominations must be received by Friday, March 16, for consideration. 
All information will be kept confidential.

Nominee Name

Question Title

* 1. Nominee Name

Nominee's Business Name

Question Title

* 2. Nominee's Business Name

Address

Question Title

* 3. Address

Website

Question Title

* 4. Website

# of years in business/career

Question Title

* 5. # of years in business/career

Nominator Name

Question Title

* 6. Nominator Name

Nominator's Business Name

Question Title

* 7. Nominator's Business Name

Address

Question Title

* 8. Address

Please complete the following three questions to the best of your ability. The Selection Committee encourages you to discuss the nomination form and process with the nominee prior to submission in order to be as complete as possible – nominations should not be a secret. (We recommend you type your answers to the following questions in a word processing application and copy and paste them into the corresponding dialog boxes.)

Introduction & Background
Provide key life, education, and family information about the nominee. Describe her accomplishments, including community service and involvement, educational pursuits, honors/awards received, etc. Has the nominee mentored or been a role model to women and girls?

Question Title

* 9. Please complete the following three questions to the best of your ability. The Selection Committee encourages you to discuss the nomination form and process with the nominee prior to submission in order to be as complete as possible – nominations should not be a secret. (We recommend you type your answers to the following questions in a word processing application and copy and paste them into the corresponding dialog boxes.)

Introduction & Background
Provide key life, education, and family information about the nominee. Describe her accomplishments, including community service and involvement, educational pursuits, honors/awards received, etc. Has the nominee mentored or been a role model to women and girls?

Entrepreneurial & Professional Endeavors
Describe the nominee’s professional/entrepreneurial endeavor(s), vision and objectives for her business, obstacles or risks overcome, status of endeavor now, future plans. What is she most proud of about her business/endeavor?

Question Title

* 10. Entrepreneurial & Professional Endeavors
Describe the nominee’s professional/entrepreneurial endeavor(s), vision and objectives for her business, obstacles or risks overcome, status of endeavor now, future plans. What is she most proud of about her business/endeavor?

Also For Consideration
Please include any additional information you’d like the Selection Committee to know about this nominee. Tell us why she should be selected for this award.

Question Title

* 11. Also For Consideration
Please include any additional information you’d like the Selection Committee to know about this nominee. Tell us why she should be selected for this award.

T