WWK Nomination Form 2017MIAMI BEACH COMMISSION FOR WOMEN
NOMINATION FORM FOR “WOMEN WORTH KNOWING”
INFORMATION ABOUT NOMINEE:
Name:
Address / Phone(s):
Place of birth:
Miami Beach resident?___ # years? ___
Miami Beach workplace? ___ # years? ____
Profession:
Interests and activities beyond the home and/or workplace:
What has nominee done to better the community (on a local, state or national
level)?
SUBMITTED BY:
Name:
Contact #(s):
Relationship to nominee:
# of years:
Please email OR mail completed form to:
Bonnie Stewart
Office of the City Attorney
1700 Convention Center Drive, Fourth Floor
Miami Beach, FL 33139
305.673.7000 #6878
Email: Bonniestewart@miamibeachfl.gov