El Planeta Powermeter 2017 Nomination Form
Powermeter 2017 Nomination Form: DEADLINE - AUGUST 18 2017

Nominate someone exceptional for The Powermeter. El Planeta needs your nomination for The Powermeter 2016-2017. El Planeta's annual Powermeter lists the 100 individuals most influential for the Massachusetts Latino community. We are looking for people who had a great 2016 making a difference in our Community in the Commonwealth.
*** NOMINATIONS DEADLINE AUGUST 18 2017 ***

ABOUT YOU (scroll down to find more sections to fill)
We need to know some information about you in order to validate this nomination.
Your name: *
(Your given name/first name: I.e. Antonio)
Your answer
Your last name: *
(Your surname/ last name: I.e. Gomez)
Your answer
Your e-mail address: *
(We might need to contact you by e-mail)
Your answer
Your cell phone / Daytime direct phone: *
(We might need to call you if we have questions about the nominee)
Your answer
ABOUT THE NOMINEE
It is important t hat you provide information about the person you are nominating. Please make sure to complete all fields. Remember that we will evaluate the candidates based on the information you provide in this form.
NOMINEE's name: *
(The person you are nominating given mane/first name: I.e. Pedro)
Your answer
NOMINEE's last name: *
(The person you are nominating surname/last name: I.e. Rodriguez)
Your answer
NOMINEE's age group: *
(You can use an age range. I.e. 30's, mid-40's, 50 to 60)
NOMINEE's company / organization / name of business / affiliation *
I.e. ABCD Enterprises, Organization for the Community, City of XYZ, Eat at Joes Restaurant, etc
Your answer
NOMINEE's position inside that company *
I.e. Human Resources Manager, VP of Marketing, Councillor, Owner, etc
Your answer
NOMINEE's e-mail address: *
(Please provide a valid e-mail address for the nominee)
Your answer
NOMINEE's cell phone or direct phone number: *
(Please provide a cell phone or direct phone number that we can use to reach directly the nominee)
Your answer
WHY ARE YOU NOMINATING THIS PERSON? *
(Please explain why do you think this person should be part of The Powermeter list as one of the 100 most influential people for the Latino Community in Mass. Explain in the paragrapgh below. You can also paste bios and any supporting information)
Your answer
WOULD YOU LIKE TO RECEIVE INFORMATION FROM PARTNERS OF EL PLANETA MEDIA? *
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