IMPACT 2026 Nomination Form

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* 1. Please fill out the information below:

Name

Company

City/Town

State/Province

ZIP/Postal Code

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* 2. How long have you been a NAPA member

Less than year

1-3 years

3-5 years

5-8 years

8+ years

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* 3. How often do you attend IMPACT meetings or events?

Always

Usually

Sometimes

Rarely

Never

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* 4. Please submit a short bio

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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* 5. Why would you be a good addition to the Group?

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* 6. Please detail any additional information you would like to provide.