Top Women in Alabama Media Nomination Form

Nominator Information

Name*

First Last

Job Title*

Email Address*

Company Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone*

Tell Us About Your Nominee

Name*

First Last

Job Title*

Email*

Company Name*

Market*

Address*

Street Address Address Line 2 City State (Must be AL) ZIP / Postal Code

Phone*

Website

Facebook

Twitter

What makes this person among the Top Women in Alabama Media?*

500 word maximum

Any other information you would like to share about the nominee (testimonials/accolades)?

500 word maximum

Upload Color Photo of Nominee (Optional)

Accepted file types: jpg, Max. file size: 1 GB.

JPG files only. File size: 1 megabyte minimum, 3 megabytes maximum. Do not use screenshots. Title the photo as "NOMINEE LAST NAME, NOMINEE FIRST NAME."

Upload Supporting Short Video Clip (Optional)

Max. file size: 1 GB.