Nomination Form

The only required* fields below are Referrer's Name, Referrer's Email, Nominee's Name, Nominee's Title, Nominee's Company, and Nominee's Email (all necessary for contact purposes) otherwise please provide as much information below as you can. Thank you for your referral!

Who is eligible to be a WBL Foundation Associate?

WBL Foundation Associates are women who should possess a title of senior vice president level or higher, preferably have direct profit-and-loss responsibility, and work in or with the health care industry. The size of the company is considered if the woman’s title is vice president or lower, i.e., the larger the company, the greater the likelihood that other titles may be acceptable. Participation in WBL is by invitation only.

What are the dues to be in WBL?

WBL does not charge its associates dues.

How does the WBL nomination process work?

Anyone may nominate an eligible woman to WBL. To nominate a woman to become a WBL Foundation Associate, simply complete the form above for each woman you would like to nominate. Then, just click the 'Nominate a Friend' button. If possible, please send a copy of the resume or bio of the potential Foundation Associate to Eleanor Whitley at .(JavaScript must be enabled to view this email address). There is no limit to the number of women you may nominate to WBL. You also may nominate women to WBL by e-mailing their contact information to Eleanor Whitley at .(JavaScript must be enabled to view this email address), or by calling WBL at (202) 955-7181. We welcome self-nominations. Should a third party nominate a woman, we let her know who nominated her so that she may thank that person for doing so.

Download This Form

You may also download this form, print it, fill it out and fax it to WBL (202) 861-3531 or mail it to: Women Business Leaders of the U.S. Health Care Industry Foundation 1227 25th Street NW, Suite 700 Washington, DC 20037

Enter the nominee's information and click the 'Nominate a Friend' button below
* Referrer's Name
* Referrer's Email
* Nominee's Name
* Nominee's Title
* Nominee's Company
* Nominee's Email
Nominee's Telephone
Nominee's Work Address
Nominee's Company Website
Nominee's Assistant's Name
Nominee's Assistant's Phone
Nominee's Assistant's Email
How did you hear about the WBL?

* Indicates a required field.

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