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Nomination Form
40 under 40 profiles Northwest Louisiana's outstanding entrepreneurs, executives, managers, and professionals in public, private, or non profit sectors. Winners are chosen based on such values as achievement, experience and innovation, vision, leadership, and community involvement.


Qualifications:
 
The individual must:
1.        Be under 40 years old as of August 31, 2008
2.        Have made am impact on his or her company or community. 
3.        Show the potential to be a leader in business or politics during the next decade. 


Submit, the following information OR provide us with the nominee's contact information and we will contact him/her and request this information. 
1. Nomination form:  Complete this form.  This gives the judges a quick overview of the nominee, his/her references and contact information.  REQUIRED FORM SHOWN BELOW
2. Resume.  Write a one page resume for the nominee that briefly outlines his/her career path. 
3. Business accomplishments:  Write a one page report on the nominee's business accomplishments. 
4. Community involvement:  Write a 1/2 page report on the nominee's community and charitable activities. 
5. Wildcard: Write ½ page on why this person should be part of the 2008 
40 under 40 class. 

NOTE:  Only nominees with a complete application will be considered. 

Submit the nomination by email to info@shreveportchamber.org, fax to YPI at 318.677.2541, or mail to YPI, 400 Edwards Street, Shreveport, LA  71101. Deadline for submission is August 31, 2008! NO EXCEPTIONS!

Name of the Nominee:
Company Name:
Company Title:
Work Phone:
Work Address:
City:
State:
Zip:
Nominee's Email Address:
Company Website:
Age of Nominee on August 31, 2008:
50 Word Description of Company:
How long has Nominee held this position?
References (May be contacted at the discretion of judges) -- (There will be three):
Reference #1 Name:
Reference #1 Position:
Reference #1 Company:
Reference #1 Telephone:
Reference #1 Email:

Reference #2 Name:
Reference #2 Position:
Reference #2 Company:
Reference #2 Telephone:
Reference #2 Email:

Reference #3 Name:
Reference #3 Position:
Reference #3 Company:
Reference #3 Telephone:
Reference #3 Email:

Name of Nominator:
Company Name:
Company Title:
Phone:
Nominator Email:
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