Black Leadership Institute Fellowship Nomination Form

The Black Leadership Institute (BLI) connects, inspires, and uplifts senior-level Black leaders shaping social impact across the country and across sectors. Through transformative programming, BLI supports Black leaders with the resources, network, and community to build upon their social, financial, knowledge, and cultural capital as they step into positions of greater power and influence.

Please provide the following information about the person you are nominating

First Name

Last Name

Email Address

Phone Number

Organizational Affiliation

Position/Title

LinkedIn Profile URL

Which BLI region is this nomination for? Please note that you or the nominee must live in one of the regional communities listed below.

Please tell us why you are nominating yourself. What leadership experience would you bring to BLI and what do you hope to gain from the program?

How long have you known the nominee?

What is your relationship to the nominee?

Please tell us why you are nominating this person. What leadership experience would they bring to BLI and what do you think they would gain from the program?

Black Leadership Institute Fellowship Nomination Form

Please provide the following information about yourself