Nomination for

Women Honoring Women

    Soroptimist International of Upper Pinellas 

Received by: ________________________ 

______________________________________________________________________________________

Name of Nominee

______________________________________________________________________________________

Address

Daytime Phone:_________________________________Evening Phone :______________________________

Personal Background:

Birthplace:_____________________________________________________________________________

Time in Bay Area: ________________________________________________________________________

Family:________________________________________________________________________________

Hobbies / Favorite Pastime:_________________________________________________________________

Professional Background:

Education:______________________________________________________________________________

Business Accomplishments:__________________________________________________________________

______________________________________________________________________________________

Current Occupation/Employer

and years of service: ______________________________________________________________________

Community Background:

Community Accomplishments:________________________________________________________________

______________________________________________________________________________________

Current Organization Affiliations: ____________________________________________________________

Volunteer Status: ________________________________________________________________________

Awards Received: ________________________________________________________________________

_________________________________________________________________ Deadline: January 22, 2006