Leadership Alabama encourages nominations of individuals who:
  • Demonstrate a commitment to community through past and present activities;
  • Demonstrate leadership ability in their chosen field through significant achievement;
  • Possess the potential for exercising substantial leadership in the future; and
  • Exhibit a personal commitment to help shape the future of Alabama.
Nominees do not fill out an application form, so you should provide evidence of these characteristics through information on this nomination form. Please complete all portions of the form. Deadline for submission of this form: January 15, 2010.

First Name: *
Last Name: *
Firm/Organization of Nominee:
Title:
Age:
Race:
Gender:
Email Address:
Phone:
Mailing Address:
City:
State:
Zip:
Nominated By:
Nominator's Email:
Please list major accomplishments in community and civic activities.
Please list awards and recognitions.
Why do you believe this person will contribute to a better Alabama?