ATHENA Award® Nomination Form

The ATHENA Leadership Award® actively supports and celebrates the ATHENA mission of supporting, developing and honoring women leaders, inspiring women to achieve their full potential—creating balance in leadership worldwide.

THE CRITERIA

ATHENA Leadership Award® Nominees must meet each of the following three criteria:

  • Demonstrate excellence, creativity and initiative in their business or profession
  • Provide valuable service to improve the quality of life for others in their community
  • Actively assist women in achieving their full leadership potential
QUALIFICATIONS
ATHENA Leadership Award® Nominees male or female may represent either the profit or not-for-profit sector, and must work or live in Washington County.
  • Previous ATHENA Leadership Award®Recipients are not eligible for nomination, however past nominees may be nominated again.
  • There is no minimum or maximumage qualification that must be met by ATHENA Leadership Award® Nominees.
COMPLETING THE FORM
  • You are encouraged to work closely with your nominee to complete their nomination.
Nominations for the ATHENA Leadership Award®must be submitted using this nomination form and format.
  • You may include three additional pages of supporting documents (articles, testimonials, etc) with your completed nomination form.
  • Visit to download this form.
Deadline for submission isMonday, March 2, 2015by 12:00 p.m.

THE PROCESS

A Selection Committee, made up of a diverse group of community leaders, will review all nominations and select the ATHENA Leadership Award® Recipient. The recipient will be announced at:

Friday, May 8, 2015

ATHENA Leadership Award® Presentation

Hilton Garden Inn, Pittsburgh/Southpointe

QUESTIONS:

Contact: Tara Gleason

724.225.3010 or

RETURN COMPLETED FORM TO:

Tara M. Gleason

Washington County Chamber of Commerce

375 Southpointe Boulevard, Suite 240

Canonsburg, PA 15317

Date ______

NOMINEE:

Name ______
Home Address ______

City______State/Province______Zip/Postal Code ______

Phone______Email______

Company/Organization______

Title/Position ______

Business Address ______

City______State/Province______Zip/Postal Code ______

Work Phone______Business Email______

NOMINATOR:

Name ______

Company/Organization ______

Business Address______

City______State/Province______Zip/Postal Code______

Phone______Email______

I. PROFESSIONAL LEADERSHIP:

Provide specific examples of how the nominee has advanced in their professional career.

II. COMMUNITY LEADERSHIP:

Providespecific examples of how the nominee has provided service to the community.

III. PERSONAL LEADERSHIP:

Provide specific examples of how the nominee has assisted women in their professional development and /or achieve this full leadership potential.

ADDITIONAL INFORMATION PERTAINING TO CRITERIA:

Include up to threepages of any additional information you feel is important for consideration of your nominee. Include awards, honors, publications, articles and/or testimonials that demonstrate service to their profession, community, and aspiring women leaders.