The 2050 Award Nomination

I'm submitting a nomination for the:

Impact AwardIngenuity Award

Nominee's Contact Information

Nominee's Name

Salutation

First Name

Middle Initial

Last Name

Nominee's Job Title*

Nominee's Company*

Nominee's Email Address*

Nominee's Phone*

About the Nominee

Nominee's Employment Sector

Describe the nominee's job and the work for which he or she is being nominated and how they demonstrated a particularly strong vision for innovation and change.*

please limit response to 1,200 characters, including spaces

0 of 1200 max characters

Describe how the individual or organization being nominated has demonstrated exceptional leadership in advancing the goals of the industry.

please limit response to 1,200 characters, including spaces

0 of 1200 max characters

Nominator Details

Your role as a nominator is an important aspect of the judging process. Please complete the fields below. Two nominators can be submitted for each nominee. Please ensure that all nominators are aware that they are being included and documented as part of this process. Upon completion and submission of the nomination, a confirmation email will be sent to the primary nominator.

Primary Nominator

Primary Nominator's Name*

First NameLast Name

Primary Nominator's Job Title*

Primary Nominator's Company/Employer*

Primary Nominator's Email*

Primary Nominator's Phone*

Is there a supporting nominator?

No, I am the only nominatorYes, there is a secondary, supporting nominator

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Would you like to receive information about Autos2050 and the 2050 Awards in the future

YesNo