Submit A Nomination

Nominations Close October 5th.

Canopy Connect

Women in Insurance — Nomination Form

Step 1 of 3

Nominations are reviewed by our panel and selected nominees may be featured on the blog and podcast.

Are you nominating yourself or someone else? *

Myself Someone else

Please choose one.

Step 2 of 3

Tell us about yourself and your work in insurance.

Your Full Name *

Please enter your full name.

Your Company / Agency *

Please enter your company or agency.

Your City and State *

Please enter your city and state.

Your Email Address *

Please enter a valid email address.

Used to notify you if you're selected.

Your LinkedIn Profile or Company Website

How Long Have You Worked in Insurance? *

Please select an option.

Why Do You Feel You Deserve This Nomination? *

Please share your story.

What's a Specific Example of Your Impact, Leadership, or Achievement in the Industry? *

Please share a specific example.

Is There Anything Else About Your Story You'd Like the Panel to Know?

Step 2 of 3

Tell us about the person you're nominating.

Nominee's Full Name *

Please enter the nominee's full name.

Nominee's Company / Agency *

Please enter the nominee's company or agency.

Nominee's City and State *

Please enter the nominee's city and state.

Nominee's Email Address *

Please enter a valid email address.

Used to notify her if she's selected.

Nominee's LinkedIn Profile or Company Website

How Long Have You Known This Person? *

Please select an option.

The Nomination

Why Are You Nominating Her? *

Please share why you're nominating her.

What's a Specific Example of Her Impact, Leadership, or Achievement in the Industry? *

Please share a specific example.

Is There Anything Else About Her Story You'd Like the Panel to Know?

About You (the Nominator)

Your Full Name *

Please enter your full name.

Your Email Address *

Please enter a valid email address.

For verification and updates.

Your Relationship to the Nominee *

Please select an option.

Step 3 of 3

Almost done — just confirm the details below.

I confirm the information provided is accurate to the best of my knowledge *

Please confirm this to continue.

I understand nominations are reviewed by the panel and selected nominees may be featured publicly on the blog and podcast *

Please confirm this to continue.

Your submission may have gone through — please check with your administrator before resubmitting.

Thank you for your nomination!

The winner will be announced October 23.

Women In Insurance Award

01 Eligibility

Who Can Be Nominated

Any woman working in the insurance industry

Based in the United States

Any experience level — from brand-new to industry veteran

Self-nominations welcome

02 Nomination Rules

Please Read Before Submitting

Anyone may submit a nomination, including self-nominations.

No limit on the number of nominations a single nominee can receive, but they must come from different people.

One person may nominate multiple different women, but can't nominate the same person more than once.

03 Key Dates

Timeline

Sept 21

Nominations open

Oct 5

Nominations close

Oct 23

Winner announced & blog feature goes live

04 How We Choose

Panel Review

Every nomination is read. The winner is selected by our internal panel, based on the strength of her story.

05 What She Wins

A Commemorative Plaque

Recognizing her achievement.

A Dedicated Blog Feature

Sharing her story with our audience.