thursday, september 2, 2010

Juice 2009 Young Professional of the Year Nomination Form

For outstanding contributions to central Iowa in 2009

The Juice Young Professional of the Year award recognizes central Iowans under 35 years old who have made substantial contributions to the quality of life in Des Moines, through social, charitable, civic, or entertainment efforts. Five finalists will be chosen by an independent panel of judges, and one will be named the YP of the Year in early 2010.

Want to print the form and mail or bring it in to our office? Get a PDF of the nomination form.

* Denotes required fields

I would like to nominate:

Last Name *

First Name *

Middle Name

Age *

Address *

City *

State *

ZIP *

Business Address *

City *

State *

ZIP *

Home Phone (area code first)*

Business Phone (area code first)*

Occupation/Profession *

Employer or Company Associated with *

How does the nominee excel in his/her profession/field? *

How did the nominee contribute to or make in impact on the community in 2009 through social, charitable, civic and/or entertainment efforts? *

Other achievements, memberships and/or offices held in 2009:

If this nominee were a finalist, what would you want people to know about him/her? *

Additional document(s)

The following files are accepted: .doc, .txt, .pdf and .zip. Files must be under 8MB. Only one file may be attached so please use a .zip file if you want to attach more than one document.

Nominator Information

Name *

Home Phone (area code first)*

Business Phone (area code first)*

Nominations may be submitted the following ways:

Online: dmJuice.com/ypoftheyear
By Mail: YP of the Year, Attn: Marketing, PO Box 957, Des Moines, IA 50306
In Person: The Des Moines Register, Attn: Marketing, 715 Locust Street, Downtown Des Moines
Click here to download the mail-in form

Additional comments and supporting documentation may be included on supplemental pages, if necessary. You may reproduce this form as long as required information is provided. In order to be considered for judging, form must be legible.

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