Lifetime Achievement Nomination Form

Nominees exemplify the following characteristics:

Outstanding character, ethics and leadership
Dedication to their company, colleagues, and Intellus Worldwide
Superior expertise, creativity, and ingenuity in developing and executing Insights & Analytics projects and methodologies
Continual willingness to dedicate time and attention to the training and mentoring of junior colleagues and the betterment of our profession

Nomination Procedure:
Complete the nomination form below. "Self-nominations" will not be accepted. In the spirit of the strong working relationships which Intellus Worldwide has nurtured between industry and consultant members, each nomination for the Intellus Lifetime Achievement Awards will require two nominators: one from an industry member and one from a consultant member. The deadline for nomination submissions is June 30. For any additional questions please contact info@intellus.org.

NOMINATOR INFORMATION -- -- If you are not logged in this information will not populate

NOTE: The nominee must be a Intellus Worldwide Member. The names of the nominator will not be disclosed to the nominee.

First Name:

Last Name:

Email Address:

Company Name:

Title:

Phone Number:

NOMINEE INFORMATION

Nominee First Name:

Nominee Last Name:

Nominee Email Address:

Nominee Company Name:

Nominee Title:

Nominee Phone Number:

Please provide bases (with specific examples) as to why the Nominee should receive the Intellus Clement-Fordyce Award. :

(Max 300 words)

Document Upload:

Please upload a document with the above response.

Submit