UMEA's Award Nomination Form
Thank you for taking time to fill-out this award nomination form. Self-Nominations are also welcome due to the fact that UMEA may not always be aware of your accomplishments.
Email address *
Name of Award *
Your Name: *
Email address and Cell phone # of the individual who is nominating: *
Nominee's Name (please provide correct spelling) *
Nominee's Company/Organization (please provide correct spelling) *
Business Mailing Address City, State, Zip Code *
Physical location if different from Business Mailing Address
Phone # 1 (Cell # preferred) *
Phone 2 (Work #)
Nominee's business is owned and operated by *
Required
Is the Nominee a current member of UMEA? *
Nominee's entity is a. . . *
How many years has the Nominee been in business? *
Number of Employees, including the Nominee *
Nominee's business engages Independent Contractors instead of Employees *
Does the Nominee hire other African-American, LatinX and minority workforce (employees and/or Independent Contractors)? *
If so, how many? *
Does Nominee sell. . . *
Required
Nominee sells products and services. . . *
Required
What type of Products and Services does the Nominee sell, and what their industry? *
Is the Nominee MWBE-Certified by any entity? *
Please describe Nominee's company growth and achievements (check all the apply): *
Required
Please describe the extent of Nominee's community involvement *
Is there anything else you want us to know about the Nominee's business--why you (if you are nominating yourself) or s/he should be considered for this award? *
I understand that filling out this form in no way, shape or form means that I or my nominee will win an award. *
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy