This nomination form is for CEO of the Year.
This award recognizes the CEO who has demonstrated significant leadership resulting in the success of their company, employees and community while promoting a strong and diverse culture.

All information will be kept confidential.
Nominate a CEO
 
Nominee Name *

 
Nominee Company *

 
Nominee Contact Information (or P.O.C. within organization). *

 
How does the nominee inspire his/her employees? Please cite at least 2 examples that illustrate the CEO's leadership style and its impact on employees. *

 
What measureable accomplishments has the company achieved over the past 12 months? Accomplishments may include a successful product launch, reorganization or rebrand, and more. *

 
Provide concrete examples of what the CEO has done to promote a strong and diverse corporate culture. (Diversity programs, women’s initiatives, volunteer opportunities, professional development, etc.) *

 
What recognition has the CEO received over the past 12 months? *

 
Please provide any additional information that we have not specifically asked for that highlights the CEO's leadership in 2016.

 
Enter 2016 revenue as a dollar range. *

All answers remain confidential to the judging process.
 
Enter percentage of change in revenue growth from 2015-2016. *

All answers remain confidential to the judging process.
 
Enter number of New England employees in 2016. *

 
Enter percentage change in number of New England employee growth from 2015-2016. *

 
Enter the number of new customers in 2016. *

 
Enter the percentage change in customers from 2015-2016. *

 
Upload a headshot of the CEO you are nominating. *

 
Enter your name and company. *

 
Enter your email address. (We will reach out to this address if we have follow-up questions). *

Thank you for your nomination.
If you have any questions contact events@masstlc.org.
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