40 Under 40 Nomination

Nominee Contact Information
Nominee Name

First NameLast Name
Birth Date (must be under 40 as of Dec. 31, 2025):

MonthDayYear
Date
Email
example@example.com
Phone Number
Please enter a valid phone number.
Job Title
Employer/Organization:
Busines Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Years Living or Working in Adams County
Nominator Information
If this is Self Nomiantion, please write "Self"
Name

First NameLast Name
Employer/Organization:
Phone Number
Please enter a valid phone number.
Qualifying Questions

Please provide detailed, specific responses. Judges are looking for clear examples, measurable impact, and demonstrated leadership.
Describe the nominee’s most notable professional achievements or milestones. How have they demonstrated exceptional leadership, innovation, or measurable results in their field or organization?(Consider including awards, promotions, projects, or measurable outcomes.)(Max 300 words)
In what ways has the nominee made a meaningful difference in Adams County? Describe their involvement in volunteer work, civic leadership, or community projects—and the tangible impact of those efforts.(For example: number of people served, new initiatives started, funds raised, or partnerships built.)(Max 300 words)
How does this individual inspire others through their actions, integrity, and example? Share a story or situation that illustrates their leadership style, resilience, or commitment to doing what’s right—even when it’s difficult.(Max 300 words)
What qualities, vision, or ambitions make this person a leader to watch in the years ahead? How do you see them shaping the future of Adams County or their professional field?(Be specific about their long-term potential and how they’re already building toward it.)(Max 300 words)
Optional Supprting Material
Résumé

Cancelof
One Letter of Support or Recommendation

Cancelof
Professional Photo or Headshot

Cancelof
Program Agreement and Consent*

By submitting this application, I acknowledge and agree that the application fee is nonrefundable. I understand that each nomination includes a one-year Individual Membership to the Adams County Chamber of Commerce and that the nominee’s information will be used to create their membership profile. I consent to participate in the Adams County Chamber of Commerce’s 40 Under 40 program and grant permission for my name, image, and likeness to be used for promotional and marketing purposes. If I am nominating someone else, I confirm that I have obtained their permission and that they have agreed to be nominated. All evaluations are conducted by independent volunteers, including chamber professionals from across the United States. No staff, volunteers, or board members of the Adams County Chamber of Commerce participate in the judging process.

Checkout

Nomination Fee

$40.00 Quantity

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Should be Empty:

Nominee Contact Information

Nominator Information

Qualifying Questions

Optional Supprting Material