LEAD ELBERT Nomination Form
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Nominator's Name (You may nominate yourself) *
Nominator's Phone Number *
Nominator's Mailing Address *
Nominator's Email Address *
Relationship to Nominee (write "self" if nominating yourself) *
Who is the Nominee's Employer? *
Do you have the authority to provide the nominee time off to complete this course? *
Do you have the authority to provide the nominee with proper funding to complete this course? *
If you answered "no" to either one of the previous questions above, please give us the name and contact of the person who can. *
Which day of the week is best for the nominee to miss a day of work? *
Nominee's Name *
Nominee's Contact Info *
Business Name *
Business Address *
Business Phone *
Business Type *
Why have you nominated this person to take part in the LEAD ELBERT program? *
Does nominee need to be considered for a partial or full scholarship for the program? *
I realize that this program requires $250 for tuition and 1 full weekday of each month to complete the course. *
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