Self-Nomination

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INSTRUCTIONS: To be considered for the class, participants must be nominated and complete an application form. Nominations are accepted year-round, but must be received by May 1st to be eligible for the next year's class. Self-nominations are encouraged. The online application for the program will be available from May 15 - June 15, 2020. All applications must be submitted by midnight on June 15th to be considered for the program. A selection committee, comprised of Leadership Iowa alumni and ABI representatives will review and select the individuals for the next class year. Individuals are notified of their acceptance in early August.

To nominate someone else, complete this form.

Complete the following form and submit for processing. If you have questions, please contact info@leadershipiowa.com or call 515-235-0570.

* denotes required field
Nominee Information
 
First Name: *
Last Name: *
Job Title: *
Company / Organization: *
Street Address 1: *
Street Address 2:  
City: *
State / Zip Code: * /
Phone Number: * xxx-xxx-xxxx
Work E-mail: *
Nomination Year: * 2020-2021
Comments:  
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