Leadership Memphis | 2023 Change Makers Nomination

Name of Nominee:*

Nominee Current Place of Employment (if appropriate:*

Nominee Title:*

Category*

Please select one.

Nominee Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Nominee Phone:*

Email*

Describe in 1500 characters or less why your nominee is a change maker?*

In 1000 characters or less, how did the nominee’s efforts result in a meaningful and measurable impact on others in Memphis?*

In 1000 characters or less, how is the Memphis change the nominee created sustainable?*

In 1000 characters or less, please describe how the nominee has inspired other Memphians to become Change Makers?*

In 1000 characters or less, How has the nominee demonstrated connectedness/collaboration in Memphis to achieve change?*

Your Name:*

Your Phone:*

Your Email:*