EKY Gala Nomination Form

1

Please select which award you wish to nominate.* This field is required.We know your nomination could meet the criteria of several awards. You are welcome to select multiple awards.

Lifetime Achievement Award

Business Person of the Year

Appalachia Leadership Award

EKY Humanitarian Award

City of the Year

County of the Year

EKY Connect Award

Healthy Community Award

Downtown of the Year

Startup of the Year

EKY Recovery Award

EKY Student of the Year

EKY Teacher of the Year

EKY Tourism Organization of the Year

2

Your information* This field is required.This information is used to follow up with you if more information is needed.

First Name

Last Name

3

Email* This field is required.This will be used to communicate with you in case your nomination requires any additional details.

example@example.com

4

Phone Number* This field is required.This will be used only if we need additional details on your nomination.

Please enter a valid phone number.

5

Which best describes your nomination* This field is required.Please select one of the following

Individual

Business

Group or Organization

City Government

County Government

School, College, or University

6

Your nomination of an individualIf you are nominating a group, organization, business, or government entity, please skip this question

First Name

Last Name

7

Your nomination of a group, business, organization, governmental entity, etc.Please provide the name of the group, organization, business, or government entity, etc. you wish to nominate. If you nominated an individual, please skip this question.

8

What county does your nominee reside in?* This field is required.Please list the county name (example: Floyd County). This is required for all nominations.

9

Share why your nominee should be recognized* This field is required.When doing this, remember to tell the who, what, when, where, and why.