Pacesetters - Prospective Nominee Form

Prospective Nominee Form

Fill out the form below to complete your nomination for the FWA Pacesetters Program. Complete nominations are due by Thursday, May 1, 2025.

If you have any questions, please do not hesitate to contact the FWA Pacesetter Committee co-chairs at [email protected].

Pacesetter Nominee Form

First Name:

Last Name:

Work Email:

Work Phone:

Email for Program Communications (with Google access)

Google access note

For access to program materials, a Gmail account or email with access to Google Workspace services is required. To sign up, go to accounts.google.com (if you prefer, you can use an existing personal email account - when you reach the prompt for "How you'll sign in" select "use an existing email account"). For assistance or questions about this requirement, contact [email protected].

Mailing Address - Street

City

State

Zip Code

LinkedIn Profile URL:

Professional Bio (200 words):

Describe your proudest career achievement(s) (200 words or less):

Describe your career aspirations and what you hope to achieve through the Pacesetter Program (200 words or less):

Describe how you have dealt with one specific obstacle in your career. What was the situation, the action(s) taken, and the outcome? (200 words or less):

High-resolution photo (300dpi in tif, png, or jpg formats; minimum of shoulders and above) for digital publication:

Upload File

Resume (ensure your file is up-to-date before submitting):

Upload File

By providing your initials below, you acknowledge the nominee's knowledge and acceptance of the Pacesetter Participant Requirements*

Date:

If you have difficulty submitting this form, please scroll up and check for required fields outlined in red.

*Pacesetter Participation Requirements

One of the primary benefits of the Pacesetter Program is networking and relationship building. Therefore, the participants must commit to being part of the Pacesetter community.
Missed Sessions:
The expectation is the participants will attend all Pacesetter workshops.
We understand that conflicts can occur. A participant can miss up to three workshops and still complete the Pacesetter program.
If the participant misses more than three workshops, we will reach out to the participant and their manager to discuss further participation in the Pacesetter program.