If you know of someone who may benefit from, contribute to, and be interested in experiencing Leadership West Virginia, please submit his/her name below. Program information and an application will be forwarded to each nominee.

Nominations may be mailed, faxed, or e-mailed (by clicking the "Submit" button.) If you choose to mail or fax this form, please print the Nomination Form and complete all questions.

Printable Nomination Form

I nominate the following person for the next class of Leadership West Virginia.

*NAME
TITLE
COMPANY
*EMAIL
ADDRESS
CITY
STATE
ZIP
YOUR NAME
YOUR PHONE
YOUR EMAIL
NOTE: Fields marked with a * are required.

Nominations may be mailed or faxed to:

Leadership West Virginia
PO Box 2789
Charleston, WV 25330-2789
Fax: 304.342.1130