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Nomination Form

PDF Nomination Form
Nomination Criteria
View Past Award Winners

 

2011 Innovator Award


Nominee Information

Nominee's Company Name*  

Description:*
Use the box below to enter text. Please address the following key points in your description:

  • What is your core business?
  • How have you redefined your business and adopted new technologies and /or practices?
  • What state programs or policies have contributed to your success?

 


Nominee Contact

Prefix:
 (Dr., Mr., Ms., etc.)
First Name:*
 		Middle
Initial:

 
Last Name:*
 
Suffix:
Corporate Title:
Dept/Division:
Company/
Organization*:
Address*:
City*:
Phone*: FAX:
( ) -     		 E-Mail*:

Nominator Information

Prefix:
 (Dr., Mr., Ms., etc.)
First Name:*
 Middle
Initial:
Last Name:*
Suffix:
Corporate Title:
Dept/Division:
Company/
Organization*:
Address*:
City*:
Phone*: FAX:
( ) -     		 E-Mail*:

 

Nominations are due by February 18, 2011.

Questions about Nomination process? Contact Southern Growth Policies Board at (919) 941-5145.

*Fields must be filled out.

On submit, you should be directed to a Thank You page confirming the completion of your registration. Within a few minutes to a few hours, you should also receive a confirming email containing the form's content. If you do not receive this email, please contact Connie Hansen.

 
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Southern Growth Policies Board, P.O. Box 12293, Research Triangle Park, NC 27709
Phone: (919) 941-5145, Fax: (919) 941-5594, Email: info@southern.org