Leadership Lowndes Nomination Form Class of 2015

To make a nomination for Leadership Lowndes, please fill out all of the fields in this form. Leadership Lowndes is continually interested in finding quality applicants for its program. Each applicant must first be nominated by someone who sees potential in that person. The nominee is then sent an application form. Finally, all applicants are screened by a special selection committee, and thirty of those applicants are chosen to be participants.

Please remember that, to be considered for Leadership Lowndes, an individual must have a background of activities and involvement which is indicative of that person's leadership potential.

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* 1. Your First and Last Name

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* 2. If you are a Leadership Lowndes alumni, please provide your class year.

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* 3. Please provide the nominee's contact information.

Name: *

Title and Company: *

Address: *

Address 2:

City/Town: *

State: *

ZIP: *

Email Address:

Phone Number:

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* 4. To your knowledge, has this individual been nominated for Leadership Lowndes in past years?

Yes

Not Sure

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* 5. Please describe why you feel this person would be a good candidate for membership in Leadership Lowndes.

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