NOMINATION FORM

The Business Link will be honouring 40 businesspeople under 40 years of age (as of March 1, 2011) who are making their mark in Niagara with business success and community involvement. We are seeking nominations for these outstanding individuals. The nomination deadline is April 15, 2011. ABOUT THE NOMINATION FORM (see pages 2 & 3) Candidates must have achieved business success and be active in civic organizations. Please fill out the nomination form completely and accurately. Please completely answer all questions and attach all necessary supporting information. In a general paragraph explain why this person is a great 40 Under Forty candidate

NOMINEE INFORMATION
Nominees Name: _________________________________________________________________________________ Nominees Company & Business Title: _________________________________________________________________ Nominees Address: _______________________________________________________________________________ Phone: ____________________ Fax: ________________________ Email:__________________________________ Nominated by Name: ___________________________________ Company: _____________________________________________ Phone: ___________________________________ E-mail: _______________________________________________

Sponsored By

Presented By

The Business Link Achievement Awards

40 Under Forty Business

Please fax or e-mail this form & supporting information before April 15, 2011 to Wendy
Smith at 905-646-5486 or info@businesslinknewspaper.com. For more information on ordering tickets call 905-646-9366.

NOMINATION FORM
History
Date of birth: ______ _____ Month Day ________ Year

How did you get started in your field of work?

What is your level of education?

Where have you worked over the last 5 years?

What have you done to excel in your industry? (Continuous training, seminars etc)

What is your current position in your company?

What are your duties in that position?

Why did you start your business in Niagara?

Business Accomplishments
Have you been the recipient of any awards? If so please give details.
The Business Link Achievement Awards 40 Under Forty Business

Have you been promoted within your organization?

How long have you been in business or at the position youre in?

What is the percentage of growth in your sales over the last 2-3 years?

Have you expanded your business over the last year? (Opened a satellite office, added employees, expanded office space etc)

What obstacles have you had to overcome to succeed?

Community Service
What organizations are you actively involved in?

What charities do you support? (Please list the organizations and involvement)

What have you done in your community to make it a better place?

How much have you given to your community? (Time and/or donations)

Why this Nominee

Why is the nominee a great candidate for the 40 Under Forty Business Achievement Award?

The Business Link Achievement Awards

40 Under Forty Business

References

(please provide two references) Phone #: Phone #:

Name: _____________________________________ ________________________________ Name: _____________________________________ ________________________________

The Business Link Achievement Awards

40 Under Forty Business