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2019 Business Excellence Award Nomination Form

NOMINATION FORM

Award nominations may be submitted by representatives from any company or organization to Prospera Business Network. Please complete and submit the electronic form on our website.

You are encouraged to self-nominate, or to collaborate with your nominee on the nomination details. Multiple award nominations are welcome; please submit separate forms for each nomination. Award finalists in each category will be notified in early to mid-September and will be recognized at the event. Winners in each category will be announced during the awards program the evening of the event, Friday, November 8th, 2019. Winners must be present at the event, or agree to arrange for a representative to attend on their behalf.

Nomination form must be submitted by 5:00 p.m. Friday, August 9, 2019

Nomination form can be submitted via a web form at: prosperaMT.org/events/awards

Contact Kris Bart, with any questions regarding the event or nomination submissions. 406.587.3113 or kbart@prosperaMT.org

Once you submit the following nomination form, you will receive an e-mail confirmation at the email address entered below. Please be sure to also check your junk/SPAM folder.

Nominator Contact Information
Please include the contact information of yourself or the person nominating the company or individual.
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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
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Nominee Contact Information
Please include the contact information of the individual or company you are nominating.
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First Name
Last Name
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If you are nominating an individual, please include their business title.
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Please see the PDF attachment of award category descriptions located on the event web page: prosperaMT.org/events/awardsdinner
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Please confirm that the nominee consents to being nominated and is willing to attend the event on Friday, November 9, 2018, or arrange for a representative to attend of their behalf.
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Pictures may be taken at this event for the purpose of promotion, advertising, publicity and marketing of the Prospera and Montana WBC services, all photos are public: Photo and Video Release (checkbox below) "By agreeing, I hereby grant permission to Prospera to photograph or video record me or the nominee and use pictures, photographs, silhouettes and other reproductions of my physical likeness as part of the Award nomination process and event. I further grant permission to Prospera to use these images for public distribution for advertising, promotion and exhibition in print or electronic means."
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Prospera event, Prospera newsletter, Email, Social Media, Word of Mouth, Prospera Staff, etc.