NOMINATOR

Name:

Address:

Tel:

Email:

Please include an alternate contact person:

NOMINEE

Name:

Position:

Years of Service with Company:

Tel:

Email:

Does the nominee know he/she is nominated?: Yes/No

Please include the following documentation:

1. This nomination form (6 copies)
2. Covering letter from CEO on company letterhead (6 copies)
3. Three pages (max) describing nominee’s leadership excellence (6 copies)
4. Five items (max) of supporting documentation (1 copy )
5. Picture and one-page bio of the nominee, with a copy on a CD (1 copy )
6. Include your $200 check payable to: Leadership Excellence Award

Please return to:

Leadership Excellence Award

Vice Admiral James B. Stockdale Center for Ethical Leadership

United States Naval Academy

112 Cooper Road

Annapolis, MD 21402-5022

CLOSING DATE FOR SUBMISSION: APRIL 30, 2007

Inquiries to Dennis Haley at the Leadership Excellence Awards

Tel: 610 783 0630 Email: DHaley@leadership-excellence-summit.com