Forty Under 40 Nomination Form

Online Nomination Form
IBJ seeks rising leaders for 22nd annual "Forty Under 40"
On February 3, 2014, Indianapolis Business Journal will recognize 40 central Indiana business and professional leaders. We are looking for people who have achieved a level of success that is rare at a young age. Examples of civic involvement and leadership outside the workplace will also be considered. Nominees must be younger than 40 as of the February 3, 2014, publication date.

Previous honorees are not eligible for nomination.

The deadline for nominations is September 27, 2013.

Nominee Information

Nominee must reside in Marion County or surrounding counties.

First Name: Required

Middle Initial: Required

Last Name: Required

Cell Phone: Required

Title: Required

Other Title:

Company Name: Required

Address: Required

Suite:

City: Required

State:

Indiana

Zip Code: Required

E-Mail: RequiredRequired

Business Phone: Required

Fax Number:

Birth Date: YYYY-MM-DD RequiredInvalid Format ex: 1980-09-23

Highest Degree: Required

College or University: Required

Summary of why nominee deserves to be in Forty Under 40

Career Achievements

Company/Employer:	Title or Job:
Accomplishments:
Company/Employer:	Title or Job:
Accomplishments:
Company/Employer:	Title or Job:
Accomplishments:

Community Leadership

Endeavor:
Accomplishment:
Endeavor:
Accomplishment:
Endeavor:
Accomplishment:

Board Positions

Board Name:	Board Title:
Accomplishment:
Board Name:	Board Title:
Accomplishment:
Board Name:	Board Title:
Accomplishment:

Other accomplishments outside of business:

Anything else notable about this person:

Nominator Information

First Name: Required

Last Name: Required

Phone: Required

E-Mail: RequiredRequired

Relationship to nominee: Required

Send any letters of recommendation or other supporting materials to Norm Heikens, Associate Editor, Indianapolis Business Journal, 41 E. Washington St., Indianapolis, IN, 46204, or email the documents to nheikens@ibj.com.