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ATHENA Award Nomination InstructionsThe ATHENA 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 ATHENA Award ® honors individuals who strive toward the highest levels of personal and professional accomplishment, who excel in their chosen field, devote time and energy to their community in a meaningful way, and forge paths of leadership for other women to follow.
THE CRITERIAATHENA Award® recipients 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 Assist women in reaching their full leadership potential
COMPLETING THE FORM Nominations for the ATHENA Award® must be submitted using this nomination form To access the electronic version of this form, please visit www.watertownny.com or email the Chamber at
[email protected]. You may include up to a maximum of three additional pages of supporting documents/pages (resume, CV, letters of
support etc.) in addition to the nomination form. The information submitted should support the award criteria of commitment, leadership, and service.
THE PROCESSA Selection Committee consisting of a diverse group of community leaders and past recipients will review all nomination forms and select the ATHENA Award® recipient.
The ATHENA Award® recipient will be announced no later than Wednesday, July 29. The award will be presented at a dinner hosted by the Greater Watertown-North Country Chamber of Commerce on Thursday, September 10, 2015, at the 1000 Islands Harbor Hotel in Clayton.
RETURN COMPLETED FORM TO: SUBMISSION DEADLINE:Greater Watertown – North Country Chamber of Commerce 4:00pm, Wednesday, July 22, 20151291 Faichney Drive, Suite #1, Watertown NY 13601e-mail: [email protected]; fax: 315.788.3369If application is e-mailed, mailed or faxed, please call 788-4400 to verify receipt.
The Greater Watertown-North Country Chamber of Commerce, in partnership with ATHENA International, presents the ATHENA Award® with the help of our community program sponsors:
ATHENA Award ® Nomination Form1291 FAICHNEY DRIVE, SUITE 1 • WATERTOWN, NEW YORK 13601 • T 315.788.4400 • F 315.788.3369
WWW.WATERTOWNNY.COM • [email protected]
2015 ATHENA Award ®
Date
NOMINEE
Name
Home Address
City State Zip Code
Phone Email
Company/Organization Name
Title/Position
Business Address
City State Zip Code
Work Phone Business Email
Fax Number
NOMINATOR
Name
Company/Organization Name
City State Zip Code
Phone Email
Fax Number
ATHENA Award ® Nomination Form I. PROFESSIONAL LEADERSHIPProvide specific examples of how the nominee has demonstrated excellence, creativity and initiative
1291 FAICHNEY DRIVE, SUITE 1 • WATERTOWN, NEW YORK 13601 • T 315.788.4400 • F 315.788.3369 WWW.WATERTOWNNY.COM • [email protected]
in their business or profession. List any special recognition, projects, or achievements and include: professional affiliations, directorships, trusteeships or other designations as appropriate.
II. COMMUNITY SERVICEList local, state, national, and international level participation. Include length of service and offices held in civic and service organizations such as charitable activities, political pursuits, religious groups, chambers of commerce, merchants’ associations, etc.
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ATHENA Award ® Nomination Form III. PERSONAL LEADERSHIPProvide specific examples of how the nominee has assisted women in reaching their full leadershippotential, and/or demonstrated support for the professional advancement of women in their career.
1291 FAICHNEY DRIVE, SUITE 1 • WATERTOWN, NEW YORK 13601 • T 315.788.4400 • F 315.788.3369 WWW.WATERTOWNNY.COM • [email protected]
IV. ADDITIONAL INFORMATION PERTAINING TO CRITERIAInclude any additional information you feel is important for consideration of your nominee. List awards, honors received publications or articles supporting services to their profession, industry or community.
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1291 FAICHNEY DRIVE, SUITE 1 • WATERTOWN, NEW YORK 13601 • T 315.788.4400 • F 315.788.3369 WWW.WATERTOWNNY.COM • [email protected]