ALF Fellow Nomination Form

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If you discuss this nomination with the nominee, please make sure they understand there is no guarantee that they will be selected. Nominations are kept on file for two years.

Questions marked with an asterisk (*) are mandatory.

Nominator Name (Your First and Last) *

Nominee's Name (person you are nominating) (First and Last) *

Nominee's Title
*

Nominee's Company *

Nominee's Work Address

Nominee's Email

Nominee's Phone Number

Have you spoken with this nominee about the ALF program and tuition costs ($13,500, some scholarship assistance is available) and, if so, do you feel confident the nominee would likely accept an invitation if offered? *

How is this person a proven leader committed to the public good, display personal integrity, and work collaboratively? What skills and/or passions would this person bring to the ALF network? *

Nominee's Ethnicity *

African American

Asian/Pacific Islander

Caucasian

Latino/a/x

LGBTQ+

Middle Eastern

Native American

Other:

Required

Nominee's Gender *

Male

Female

Nonbinary/Third Gender

Nominee's Profession by Field (please choose one) *

Agri-Business

Arts

Association

Community Activist or Representative

Corporate

Education

Elected Official

Environment

Faith

Government

Health

Labor

Public Safety

Law Professions

Media

Nonprofit

Philanthropy

Small Business

Required

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This form was created inside of ALF Mountain Valley Chapter.