2020 Top 30 Under 40 Nomination Form
You have been nominated by a colleague for Kootenai County’s Top 30 Under 40 award. Please fill out the following form to be submitted to our judging panel for review. Once reviewed, a judge may schedule a follow up interview for further consideration if needed.
Eligibility:
 • You can win this award a Max of 3 times before you're 40. We appreciate your hard work and dedication to making Kootenai County a great place to work and live. 
• Must be under 40 years of age by December 31, 2020. Yes, that is what “under 40” means… 
• Nominee does not have to be a member of KCYP, Chamber of Commerce, or any other specific club/membership to be nominated. 
• Must reside in Kootenai County

Please read through the entire form before filling out, this will help you from duplicating information.

CURRENT INFORMATION
Please only list things that are current as of this nomination form

Full Name		
Current Employer		
Title / Position		
Current Organizations		

		

SNAPSHOT OF PAST
Please list any previous items that the judges may find relevant

Previous Employers & Titles		

		
Educational Background		

Previous Organizations		

		

		

Professional Accomplishments
Please use this section for accomplishments relating to your career.

2020 Recognition Awards Accomplishments		

		
Previous years Recognition Awards Accomplishments		

		
Please use this space, if needed, to further explain anything above.		

		

Community and Philanthropic
Please use this section to explain your focus and dedication to Kootenai County
2020		
Volunteerism		
&		
Philanthropic		
Focus		
		
Previous years		
Volunteerism		
&		
Philanthropic		
		
Focus		
		
Please use this		
space, if needed, to		
further explain		
anything above.		

All the Rest

Future Goals (can be personal, professional, or community related)		
What does achievement look like to you?		
What does leadership mean to you? If you are in any positions of leadership please explain also.		
Anything else the judges should know?		

Please submit this form to: nominations@kootenaicountytop30.org