I would like to nominate the individual listed below to be a candidate for Man or Woman of the Year.  This person is community minded, ambitious and is committed to the mission of The Leukemia & Lymphoma Society: Cure leukemia, lymphoma, Hodgkin's disease and myeloma, and improve the quality of life of patients and their families. 

I understand that this nomination form in no way commits the nominee to become a candidate.  All nominees are sent information about the event and an invitation to accept or decline their candidacy.

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Candidate Information

First Name*
Last Name*
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Zip/Postal Code*
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Email
Company Name
Title
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Comments
Please direct questions to Campaign Coordinator Nicki Hyser at (763) 545-3309, ext.102 or hysern@lls.org.