WBL 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!

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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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 Adrienne Colburn at acolburn@ebglaw.com. 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 Adrienne Colburn at acolburn@ebglaw.com, 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.

  • If you have any questions regarding the nomination process, please call the WBL Foundation at (202) 955-7181.
  • To learn more about WBL, please contact WBL Staff.
  • You can also learn more about our dynamic Advisory Board on the WBL Advisory Board page.
  • To learn more about the WBL Foundation, please view our fact sheet and list of frequently asked questions (FAQ).

    • 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