Women of Innovation Form - Technology Association of Iowa

Women of Innovation Form

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To make a nomination, please complete the following information request
Award Category:
Nominee
First Name:
Last Name:
Organization/Institution:
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Address 2:
City:
State:
Zip Code:	(e.g. xxxxx or xxxxx-xxxx)
Telephone:	(e.g. xxx-xxx-xxxx)
E-mail Address:
Nominator
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Telephone:	(e.g. xxx-xxx-xxxx)
E-mail Address:
Please submit 500 words explaining how the nominee has met the award criteria and its impacting result
Please submit no more than 500 words explaining how the nominee has met the award criteria and its impacting result. Please refer to award and judging definitions listed in the previous page.