2014 Woman of Distinction

 

     

    Please complete this nomination form as completely and accurately as possible.  Your nominee must reside in the 58th Senatorial District (http://www.nysenate.gov/district/58).  

    (Answer areas can be expanded by grabbing the lower-right corner with your pointing device.)

    The person you are nominating as a Woman of Distinction

    Your name and contact information -- telephone and email

    Your organization and title -- please include address, telephone and email

    What College or University did the Nominee graduate from? Year and Degree

    Please list and detail other degrees and/or certifications awarded to your nominee (enter "none", if none)

    Please list all academic awards and achievements

    Please include award titles and year of award, as well as a brief description (enter "none", if none)

    (Enter "none", if none)

    (Enter "none", if none)

    Please include branch of service, years served, rank and discharge status (enter "none", if none)

    Tell us about the nominee's work history (enter "none", if none)

    Please describe your nominee's major accomplishments. Include, if any, obstacles that have been overcome

    Additional information you believe the selection committee should consider