| NOMINEE:
___________________________________________ |
| Employer
and Title: ____________________________________________________
|
|
Address: _____________________________________________ |
| City:
____________________________State:_____Zip:________ |
| Phone:
(W)(_____)________________(H)(_____)_____________
|
| Recommendation
for: q
Board q
Committee: ___________________ |
|
Describe skills and talents of the nominee:
|
|
To
your knowledge, what access to resources does this nominee possess?
|
|
Why are you recommending this person?
|
| Nominator:_____________________________
Date:_______________ |
|
| Source: Management Cornerstones, Inc. Milwaukee,
WI |
