Mujeres Poderosas Nomination Form
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Nominator's Information
First and Last Name *
Email Address *
Phone Number *
Your relationship to nominee: *
Ex: Friend, mentor, supervisor, etc.
Nominee's Information
Nominee's Name *
Business/Company/ Organization *
Nominee's Title *
Nominee's Business/Company/Organization Website *
Nominee's Email Address *
Nominee's Phone Number *
Describe how the nominee is a mujer poderosa in her community. *
Additional Comments?
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