Jump to Content

Nomination Form

About | Nomination Criteria | Online Nomination Form | Printable Nomination Form

* Indicates a Required Answer

Person/Business submitting the nomination*


Contact Phone Number *

- -

Contact Email (preferred, but not required)

* Indicates a Required Answer

Business to be nominated*


Number of employees (if known)

Phone Number (if known)

- -

Business branch or location



In three hundred words or less please explain why you feel this business is worthy of recognition from the Washington State Secretary of State’s Office. Please include all contributions, accomplishments, impacts and/or anything else that might showcase the business. If attached, please write “See Attached” in the space provided below.

Why? *

Additional Comments
Is there anything else of which the Secretary of State should be aware?

Do you have photos you would like to add?


Upload photos   Clear photos

Photos uploaded:

Photos have been uploaded.

Upon signature, the nominator is certifying that all information given on this form is true and accurate to the best of his/her knowledge.

Full Name *


Today's Date


* I certify that all information given is true and accurate to the best of my knowledge.

Processing...

Processing
Nominator
1
Nominee
2
Why?
3
Comments
4
Certification
5
Complete
6