Nomination Form

Please complete the online form to nominate a woman or company for the Florida Women in Insurance Leadership Awards. Nominees will be notified once nominated. 
Nominations will be accepted through February 9, 2022.

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* 1. Name of the candidate

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* 2. Email address of candidate

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* 3. Business name or organization of candidate 

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* 4. Title or role of candidate

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* 5. Nomination category (select one)

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* 6. Describe why you are nominating this candidate for the specified award above

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* 7. Additional information (if available) 

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* 8. Your full name

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* 9. Your email address

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* 10. May we share with the nominee who submitted the nomination?

Nominees will be notified via email that they have been nominated for the Florida Women in Insurance Leadership Award and their nomination will be made public. 

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