Nomination

To be eligible for consideration, nominees must:

Have significantly impacted the insurance industry
Have an Iowa connection
Serve as a role model for young people and others in the industry
Exhibit the highest standards of ethical conduct

Nominations for 2021 have closed. Those not selected will remain eligible for five years. Please check back after January 1, 2022 for deadline information for 2022 nominations.

Step 1 of 3

Nominee Contact Information

Name(Required)

First Last

Is the nominee deceased?(Required)

Yes

No

Who would accept the award if inducted?(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Day Phone(Required)

Cell Phone

Email(Required)

Nominee Biographical Information(Required)

Summary of contributions to the insurance industry and community.(Required)

Other documentation to support guideline considerations, including letters of recommendation.(Required)

Drop files here or

Accepted file types: jpg, png, pdf, docx, csv, xls, xlsx, doc, Max. file size: 256 MB.

Nominator Contact Information

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Day Phone(Required)

Cell Phone(Required)

Email(Required)

Email

This field is for validation purposes and should be left unchanged.

Submit Nomination

Nominee Contact Information

Nominator Contact Information

Induction Ceremony

Quick Links

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