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Copper Star Award Nomination Form
Δ
Step
1
of
2
50%
Eligibility Requirements
(Required)
Is a Washington County resident
Has worked in the region for 5+ years
Leads by example and shows excellent integrity
Is not an immediate family member of a current/former PlanNorth employee
Is not an executive leader, community award recipient
Solopreneur Eligibility: To qualify for the Copper Star Award as a solopreneur, the nominee must independently own and operate their business without employees. Business owners with employees are not eligible for consideration in the solopreneur category.
Nominee Information
Name
(Required)
Phone
(Required)
Email
(Required)
Current Employer
(Required)
Occupation
(Required)
Involved Organizations
(Required)
Nominator Information
To Our Nominators: Your name and contact information are required for your nomination to be eligible for consideration. Nominations submitted without this information will not be considered. If you wish to remain anonymous to the individual you are nominating, please select the checkbox below. When this option is selected, your information will remain confidential and will not be shared with the nominee. We require your contact information so we may reach you if we are unable to contact the nominee or if additional information is needed.
Name
(Required)
Phone
(Required)
Email
(Required)
Would you like to remain anonymous?
(Required)
I prefer to remain anonymous.
Nomination Questions
Example of how the nominee leads by example
(Required)
Example of how the nominee shows integrity
(Required)
Example of how the nominee shows work ethic
(Required)
Example of how the nominee lends a helping hand
(Required)
1 work-related and 1 character reference for the nominee
(Required)
A verse or quote that embodies the nominee
(Required)
Why are you nominating this person?
(Required)
Solve this in order to submit form : 5-2
(Required)
CAPTCHA
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