Nominee Information

Please provide us with full contact information for the nominee.
If you have difficulties filling in this 'on line' survey, please email your nomination to Stewart Duncan at

* Salutation

* First Name

* Middle Name

* Last Name

* Company Name

* Job Title

* Company Street Address

* City

* Postal Code

* Direct Phone Number (office/cell)

* Company FAX

* email address

* Website

* Age (as of December 31, 2013)

* Give a brief description of the nominee’s professional achievements. Suggestions: include the nominee’s recent significant business accomplishment, or past distinctions and awards. (Limit 200 words)

* Tell us about the nominee's level of expertise. Suggestions: include the nominee's educational qualifications, the name of the institution they graduated from, their professional memberships or designations, and years of work in their field. (Limit 200 words)

* Tell us about the nominee’s leadership abilities and experience. Suggestions: demonstration of nominee’s leadership and innovation, demonstration of company growth due to nominee’s leadership. (Limit 200 words)

* Tell us about the nominee’s community involvement. Suggestions: include positions on boards (charitable organizations or professional organizations), explain the nature of their involvement and how it has advanced the goals of the organization, and include any distinctions and awards for community service. (Limit 200 words)

* In summary, tell us what makes this nominee unique and outstanding. (Limit 200 words)

* Give some information about the nominee's company that reflects its size (examples: number of employees, annual revenues, etc.)