IRELAND’S MOST POWERFUL WOMEN: TOP 25 AWARDS TRAILBLAZERS (For reference purposes only. All Nominations must be submitted online at https://top25.ie)
NOMINATOR INFORMATION Sal:
First Name:
Title:
Company/Organisation:
Address:
Town:
EIRcode (If applicable):
Country:
Telephone:
Email:
Executive Assistant Name:
Executive Assistant Email:
Last Name:
County / Postcode:
Executive Assistant Telephone:
How did you hear about the Top 25 Awards? Print Media Broadcast Media
Colleague
WXN Partner
WXN Website
E-vite
Letter from WXN
Other:
NOMINEE INFORMATION Sal:
First Name:
Last Name:
First Name Phonetics:
Last Name Phonetics:
Title:
Company/Organisation:
Address:
Town:
EIRcode (If applicable):
Country:
Telephone:
Email:
Date of Birth:
Executive Assistant Name:
Executive Assistant Email:
Executive Assistant Telephone:
County / Postcode:
Has the Nominee previously won the Award? Women who have won an Award twice are eligible for being inducted into the WXN Hall of Fame.
If yes, what year(s)? How many direct reports does the Nominee have? How many indirect reports does the Nominee have? To whom does the Nominee report? (Name, Title, Company)
Nominee’s Head Office Information Please fill in the following if Nominee’s head office information is different than above Company/Organisation: Address: Town:
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IRELAND’S MOST POWERFUL WOMEN: TOP 25 AWARDS TRAILBLAZERS (For reference purposes only. All Nominations must be submitted online at https://top25.ie) County / Postcode: EIRcode (If applicable): Country: Please provide a brief overview of the Nominee’s organisation (Maximum 160 characters, approximately 25 words):
Industry Type (Please select all that apply): Aerospace and Defense
Airline
Automotive
Consumer Goods
Electronics and High Tech
Energy
Financial Services
Forest Products
Health Services
Human Services
Insurance
Life Sciences
Media and Entertainment
Metals and Mining
Non-Profit
Oil & Gas
Public Sector
Real Estate
Retail
Telecommunications
Travel
Utilities
Other:
TRAILBLAZERS CATEGORY QUESTIONS Each question must be answered in a maximum of 2500 characters (approximately 400 words). Breaking New Ground or Traditional Barriers: How has the Nominee broken new ground or traditional barriers?
Impact of Contribution on Irish Society: How has the Nominee had a measurable impact on Irish society?
Vision and Leadership: How has the Nominee demonstrated vision and leadership in her chosen field and how does she act as a role model for others to emulate? Community Service: How does the Nominee demonstrate her commitment to the community?
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IRELAND’S MOST POWERFUL WOMEN: TOP 25 AWARDS TRAILBLAZERS (For reference purposes only. All Nominations must be submitted online at https://top25.ie)
CONFIRMATION OF TRUTH OF INFORMATION AND RELEASE I understand that the detailed financial information is shared only with the 2-3 judges in the category, the Advisory Board Chair and a two-person secretariat. I understand that each of these individuals has signed a confidentiality agreement in accordance with the Nomination process. If my Nominee is selected as a Top 25 Award Winner, I hereby authorize the release and use, in connection with the Ireland’s Most Powerful Women: Top 25 of their name, company’s (or organisation’s) name, non-financial information, photographs, video or audio recordings in any form of media, from whatever source. I agree that no compensation shall be due me or my company for such usage.
ADDITIONAL DOCUMENTS (to be uploaded) 1. Internal Letter of Reference (one page maximum) May be provided by anyone within the organisation of the Nominee, including a member of the organisation’s board of directors. 2. Nominee’s Digital Headshot (High-resolution, colour image) Minimum 500kb – Maximum 2mb 3. Nominee’s Biography (one page maximum)
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