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Nomination Form

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  • Nomination Form



Nominations for 2023 are closed

The nomination process is an open one: that is anyone may nominate a candidate, and candidates may nominate themselves, using the form below. Please fill out all fields and click submit once finished. Or download a printable version of the form here, fill out and send to maria.neilson@ansamcal.com. Nominations for 2023 are closed. Nominations for 2024 are open, but we advise that you send the form closer to that date, in March-April 2023. 

You may review the awards categories here.

You will not receive an acknowledgement from this website immediately after submitting this web-based form. You will receive an acknowledgement within 24 hours, from our Programme Director. 

    Nomination Form

    AWARD CATEGORY (Select one)

    CANDIDATE’S NAME AND PERSONAL INFORMATION


    CANDIDATE CONTACT INFORMATION


    References

    Any endorser should be able to substantiate the candidate’s contributions by providing explicit
    detail from personal knowledge




    (Track record of significant accomplishments, awards, recognition of work, standing in their field)

    for Entrepreneurial Category only

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