Be a Voice Nomination Form

Deadline for Submission – April 24, 2023

Criteria for BE A VOICE Award Nominee

Resides or works in Worcester.
Exhibits a high level of professional or volunteer achievement and leadership skills.
Generates significant impact on the Greater Worcester community through her endeavors.
Demonstrates passionate commitment to a cause through her activities.
Is highly respected by her peers and is a role model for other women in her field.

Nominator Information

Your Name *

First Name

Last Name

Occupation

Employer

Work Address

Country

Address 1

Address 2

City

State

ZIP code

E-mail *

Telephone #

Home Address

Country

Address 1 *

Address 2

City *

State *

ZIP code *

Awards *

Which award(s) would you like to nominate someone for?

Amplify Award: This award is to recognize a corporate leader in our community who uses her position and influence to amplify young girls’ voices and goals.

Speaking Up Award: This award is to recognize a woman in the community that uses her time and influence to support and encourage young girls in the community.

How do you know the nominee(s)? *

Amplify Award

This award is to recognize a corporate leader in our community who uses her position and influence to amplify young girls’ voices and goals.

Nominee Name

Title

First Name

Middle name(s)

Last Name

Generational

Credentials

Occupation

Employer

Work Address

Country

Address 1

Address 2

City

State

ZIP code

E-mail

Telephone #

Home Address

Country

Address 1

Address 2

City

State

ZIP code

How has your nominee used their position & influence to contribute to girls’ initiatives in their community?

Does the nominee provide leadership or mentorship to others in her field? If so, describe how. Is she a leader in professional associations, industry groups, chambers of commerce, etc.?

Additional community impact, career and other information to consider:

Speaking Up Award

This award is to recognize a woman in the community that uses her time and influence to support and encourage young girls in the community.

Nominee Name

Title

First Name

Middle name(s)

Last Name

Generational

Credentials

Occupation

Employer

Work Address

Country

Address 1

Address 2

City

State

ZIP code

E-mail

Telephone #

Home Address

Country

Address 1

Address 2

City

State

ZIP code

How has your nominee contributed to her community?

Is the nominee a leader in the community? If so, describe how. For example, is she an active volunteer and in what way? If working in the nonprofit sector, is volunteer time given outside her own organization?

Additional community impact, career and other information to consider:

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Be a Voice Nomination Form

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