2017 40 under 40 nomination form
Nominee
The name of an entrepreneur, executive, and/or professional you wish to nominate that works in the Greater Omaha, Sarpy County and Council Bluffs area and under the age of 40 (by December 31, 2017). If multiple nominations are received, the first entry will be considered the official nomination.
Your answer
Current Position
Nominee's current job title
Your answer
Age
(as of December 31, 2017)
Your answer
Birthdate
(must be included)
MM
/
DD
/
YYYY
Number of years in career
Your answer
Nominee's E-mail address
Your answer
Company/Organization
Name of business or organization.
Your answer
Nominee's phone number
Your answer
Company Address
Your answer
City
Your answer
State
Your answer
Zip code
Your answer
College(s) nominee attended and degree(s) earned
Your answer
Business accomplishments
(job responsibilities, special projects, business related affiliations)
Your answer
Achievements, awards, special recognitions
Your answer
Nominated by
Your answer
Nominated by - Title
Your answer
Nominated by - E-mail address
Your answer
Nominated by - Phone number
Your answer
Nominated by - Company
Your answer
Nominated by - Address
Your answer
Nominated by - City
Your answer
Nominated by - State
Your answer
Nominated by - Zip code
Your answer
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