The Root 100 2013 Nomination Form
The Root is seeking nominations for the 2013 list of The Root 100. Each year The Root 100 identifies the 100 most influential African Americans, 45 and under.

We are seeking nominees of exceptional achievement from any field between the ages of 25 and 45 years old who live and work in the United States. Special consideration is given to their achievements over the past year.
Sign in to Google to save your progress. Learn more
What is the nominee's name? *
What is the nominee's title?
What is the nominee's field? *
What is the nominee's organization or company?
What gender is the nominee? *
In a couple sentences, please explain why the nominee fits the criteria for the Root 100. Please note any major accomplishments you are aware of, especially within the past year.
What is the nominee's email address?
What is the nominee's telephone number?
What is the nominee's name on Twitter? (A Twitter account is not necessary to be nominated.)
Are there any web sites you'd recommend to learn more about the nominee?
What is your email address? *
What is your name?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms