40 Under 40

Nominee's Name*

Nominee's Email*

Nominee's Phone*

Nominee's Birthday*

Nominee must be under 40 years of age

Nominee's Company*

Nominee's Title*

Education

Philanthropic Involvement

Business Success

What kind of difference have they made in their industry?

What are some examples of this person's entrepreneurship or creativity?

This person deserves to be honored because:

Your Name*

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Your Phone

Your Company*

Any additional comments?

Phone

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