2026 Leadership Pinebelt Nomination Form

The Leadership Pinebelt program, an initiative of the Area Development Partnership (ADP) Chamber of Commerce, encourages the nomination of emerging community leaders who have demonstrated leadership in their chosen field, who have exhibited interest and commitment to the welfare of the Greater Hattiesburg Area of Forrest, Lamar, and Perry Counties, and who have the potential for exercising substantial leadership in the future. Every effort will be made to ensure that the program reflects the diversity of the community. Participation is limited; only twenty (20) class members are selected each year. Age limit: 21 – 45. Nominations are due 5:00 p.m. Friday, January 23, 2026. Those not selected are encouraged to reapply in subsequent years. The ADP will, upon receipt of this form, send an application to the nominee to obtain information necessary for consideration. Multiple nominations are encouraged.

I nominate,

Name

First Last

Age

Title & Place of Employment

Phone

Enter Email Confirm Email

Nominated by:

Name

First Last

Place of Employment

Enter Email Confirm Email

Are you a Leadership Pinebelt Alumni?

Yes

If yes, please list the year.