Email address and Cell phone # of the individual who is nominating: *
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Nominee's Name (please provide correct spelling) *
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Nominee's Company/Organization (please provide correct spelling) *
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Business Mailing Address City, State, Zip Code *
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Physical location if different from Business Mailing Address
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Phone # 1 (Cell # preferred) *
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Phone 2 (Work #)
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Nominee's business is owned and operated by *
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Is the Nominee a current member of UMEA? *
Nominee's entity is a. . . *
How many years has the Nominee been in business? *
Number of Employees, including the Nominee *
Nominee's business engages Independent Contractors instead of Employees *
Does the Nominee hire other African-American, LatinX and minority workforce (employees and/or Independent Contractors)? *
If so, how many? *
Does Nominee sell. . . *
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Nominee sells products and services. . . *
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What type of Products and Services does the Nominee sell, and what their industry? *
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Is the Nominee MWBE-Certified by any entity? *
Please describe Nominee's company growth and achievements (check all the apply): *
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Please describe the extent of Nominee's community involvement *
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Is there anything else you want us to know about the Nominee's business--why you (if you are nominating yourself) or s/he should be considered for this award? *
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I understand that filling out this form in no way, shape or form means that I or my nominee will win an award. *