2022 Women of Impact Nominations

What is Women of Impact?

In honor of Women’s History Month, the 76th Assembly District is calling for nominations to spotlight the efforts of our extraordinary women in the 76th Assembly District. All people who identify as a woman of all ages who live, work, attend school, or volunteer in the 76th Assembly District (Oceanside, Vista, Carlsbad, Encinitas, Camp Pendleton and surrounding areas) are eligible for nomination. Please fill out this form if you would like to submit a nomination for woman who has positively impacted the communities and neighborhoods in the past year.

Nomination Deadline: Friday, March 4th at 11:59 pm




NOMINEE INFORMATION
Name
Address:
If nominee is not a resident of the 76th Assembly district, but works or is involved in the district:
Nominee's Work Address:
Nomination categories: For which category are you nominating this person?
(Please select one or two areas in which the nominee has contributed significantly in their community.)
Nomination Category
Tell us about this person: Please provide a description of your nominee, emphasizing significant contributions to their community and how the individual, through volunteerism, has positively impacted the communities in which they serve.

Optional: You may upload a typed article, press release, web links, or newsletter
One file only.
200 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, .



NOMINATOR INFORMATION
Please provide your information in case we need to contact you for additional information.
Name
Address