We're looking for Australia's most powerful part-time workers and need your help. In order to come up our power list, we'd love to hear your ideas of influential senior men and women in the public and private sectors who are genuinely working part-time.

Please note, this information will be shared with ProfessionalMums.net for research purposes, but will not be published anywhere prior to contacting you first.

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* 1. Name:

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* 2. Email:

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* 3. Mobile phone number:

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* 4. Name of person you're nominating (this can be yourself):

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* 5. Organisation:

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* 6. Position:

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* 7. Number of direct reports (if applicable)

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* 8. Current working arrangement, including details of flexibility (how many days/hours/working from home etc):

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* 9. Any comments on nominee's career path:

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* 10. Any additional comments. What makes this person powerful?

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* 11. What do you believe organisations could do better with regards to flexible working?

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* 12. Anything you would like to see in terms of government policy in this area (childcare, right to work flexibly etc)?

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