2027 AMSA Professional Awards - Intent to Nominate Form- Signal Service and R.C. Pollock

Intent to Nominate Form

I have reviewed the eligibility requirements for the following awards and intend to nominate myself or the listed AMSA member for the selected award:

1. Please select the following award you wish to nominate yourself or a another AMSA member for:

2. Are you self-nominating for the selected award?

Your Name *This question is required.

Your email *This question is required. This question requires a valid email address.

Name of Nominee *This question is required.

Nominee's email address *This question is required. This question requires a valid email address.

Number of years the nominee has been a professional AMSA member (if known)

Name of nominator

Email address for nominator This question requires a valid email address.