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Insurance Business America’s Elite Women report will celebrate the industry’s female trailblazers - offering well-deserved recognition for the hard work, determination, and inspiration each individual provides.

If you are, or you know, a US insurance professional who deserves a spot on the Elite Women list, fill out the form below. Self-nominations are accepted and encouraged. Nominations should focus on achievements and initiatives from the past 12 months.

All nominations are completely free.

The final Elite Women list will be selected with the guidance of an independent advisory panel, and will be featured in June in Insurance Business America magazine and on the website.

Entries close Friday, March 12, 2021.

For questions/clarifications, email trixy.kalalo@keymedia.com

Insurance Business America is committed to promoting diversity and inclusion in the insurance industry. Survey participants are invited to nominate industry professionals contributing to the success of their industry, regardless of race, sexual orientation, religion, ethnicity, national origin, disability, or age.

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* 1. Nominee Information

Name:

Job Title:

Company:

City:

Email:

Phone Number:

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* 2. Why do you think the nominee is a woman of influence? Please provide details about her professional accomplishments, initiatives and innovations and contributions to the insurance industry, focusing on standout achievements from the past 12 months. The more specifics you can provide, the more likely we’ll be able to feature her.

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* 3. How has this nominee contributed to diversity and inclusion in the workplace and/or the industry?

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* 4. Why else should the nominee be considered for the Elite Women list? For example, volunteer roles, charity work, accomplishments and positions held outside of the industry etc.

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* 5. Should the nominee be selected for IBA Elite Women 2021, please indicate whether we should reach out to the nominator or the nominee directly for further information:

Contact nominee

Do not contact nominee (contact nominator - provide information below)

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* 6. Nominator contact information:

Name:

Company:

City:

Email:

Phone Number:

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* 7. Please check the box below to confirm that the information provided in this submission is accurate to the best of your knowledge. If the above nomination is successful, you accept that any and all information provided (unless otherwise marked) may be published in Insurance Business America magazine and website and will not be subject to an approval process.

Yes, all the information provided is accurate.