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Nomination Form

Person/Business submitting the nomination *

Company or Business being nominated*
Business branch or location

In three hundred words or less, please explain why you feel this business is worthy of recognition from the Washington State Secretary of State's Office. Please include all contributions, accomplishments, impacts and/or anything else that might showcase the business. If attached, please write "See Attached" in the space provided below.

Is there anything else of which the Secretary of State should be aware?


Upon signature, the nominator is certifying that all information given on this form is true and accurate to the best of his/her knowledge.


1 Nominator
2 Nominee
3 Why?
5 Certification
6 Complete