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. The nominees will be judged on the written information submitted and outside research by the judges. Be sure to include as much detail as possible. If we need additional information we will reach out to you.

There is a $50 application fee that will be collected before you submit this form. This fee covers the processing and review of your nomination.

*If the nominee has won in the past 5 years they will not be eligible.*
Nominate a CEO
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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 (i.e. changed from a premise based business to a cloud based business while still growing revenue). *

 
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 2017.

 
Enter 2017 revenue as a dollar range. *

All answers remain confidential to the judging process.
 
Enter percentage of change in revenue growth from 2016-2017. *

All answers remain confidential to the judging process.
 
Enter number of New England employees in 2017. *

 
Enter percentage change in number of New England employee growth from 2016-2017. *

 
Enter the number of new customers in 2017. *

 
Enter the percentage change in customers from 2016-2017. *

 
Upload a headshot of the CEO you are nominating. *

 
Enter your name and company. *

 
There is a $50 application fee that will be collected before you submit this form. This fee covers the processing and review of your nomination. *

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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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