Women in High Tech Nomination Form

Name of Nominee *

Nominee's Contact Email *

Nominee's Contact Phone#*

High Tech Woman of the Year (Significantly influenced and impacted her industry/company/community)High Tech Rising Star (Demonstrates innovation, initiative, drive and leadership)High Tech Community Service (Consistently contributes her time/resources/expertise to the industry and community)High Tech Entrepreneur (Demonstrates continued success in starting and running her business, with significant impact in her industry or company or community)High Tech Mentor (Dedicates her time and initiative to help others succeed)

Name of Nominator *

Nominator's Contact Email *

Nominator's Contact Phone#*

Please describe, in 200 words or less, why this nominee deserves to be recognized in this category.

Please list any awards, designations or accomplishments received by the nominee.

In 200 words or less, please add any additional comments for consideration.