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Nominate a Candidate

If you are interested in being the next Man or Woman of the Year or would like to nominate someone you know, please fill out our official nomination form.

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   Man & Woman of the Year Registration Form
YES! I will participate in the Man & Woman of the Year competition to benefit The Leukemia & Lymphoma Society. By sending in this form, I am pledging to raise a minimum of $1,500 for the fight against leukemia, lymphoma and blood cancers.
I would like to nominate a candidate for the Man & Woman of the Year.
Candidate/Nominator Contact Information*
Home Address*
City*
State*
Zip/Postal Code*
Phone*
Email*
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Company
Title
Address
Work Phone
Work Fax
Email*
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   Nominee Information
Name of Candidate Nominee
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last updated on 01/25/05
The Leukemia & Lymphoma SocietyŽ (LLS) is the world's largest voluntary health agency dedicated to blood cancer. The LLS mission: Cure leukemia, lymphoma, Hodgkin's disease and myeloma, and improve the quality of life of patients and their families. LLS funds lifesaving blood cancer research around the world and provides free information and support services.
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