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Icons & Phenoms Nomination

By: Scott Baughman October 10, 2018

Nomination form for the Mecklenburg Times Icons and Phenoms

Nomination Form
Name of Nominee
First Last
Title
Name of Firm/Organization
Business Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone Number
Email
Education (School, graduation date, type of diploma, degrees, technical training)
Business accomplishments (job responsibilities, special projects, business-related affiliations)
Community involvement (pro bono, nonprofits, civic, state and national organizations)
Achievements and Awards
Supporting Documents (Optional)
Please upload any supporting material (articles about the nominee, resume, etc.) via the forms below. Additional material may be sent to [email protected]
File
Max. file size: 24 MB.
File
Max. file size: 24 MB.
File
Max. file size: 24 MB.
File
Max. file size: 24 MB.
File
Max. file size: 24 MB.
Nominator Information
Name
First Last
Title
Firm/Organization
Phone
Email