VIP List nomination form

VIP List Nomination 2021

Complete this form to nominate an individual for The Daily Record's 2021 VIP List. Please know that all fields are required. The fee for this nomination is $20, payable by credit card.

Nominations close June 3, 2021.

Nominees are eligible if they are born after Jan. 1, 1981.

To be eligible for this award, the winner must live in or work in Maryland at the time of judging. Honorees for this award are chosen by a panel of judges comprised of past honorees and business leaders.

Nominee's Name*
First Last
Company/Affiliation*
Work Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Enter Email Confirm Email
Why do you think this person is a Very Important Professional?*
Your Name*
First Last
Your Email*
Phone*
Notify me by email with special offers and events, including information about this event.
- Yes
Once the nomination form is submitted, an email will be sent to your nominee with the application link. The application must be completed to be considered for VIP.
Product Name
Total
$0.00
Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name