Awards 2012
2012 Conference Packet
NABSE Awards Nomination Form Submission Guidelines: 1. Please type or print all entries. 2. Please use one form per nomination. You may duplicate this form as needed. 3. Staple all supporting documentation to the back of this form. Label each supporting document with the name of the award category and the nominee’s name in the upper right corner. You may write on the back of the form. 4. If you are sending the nominating packet electronically, please have all supporting documents follow this form when scanning the packet. 5. Please fill in this form completely. Award Category: About the Nominee: Nominee
Title
Institution/Company Address City
State Zip
Work Telephone
Fax
Email Address Home Address City
State Zip
Home Telephone
Email Address
Web links: Is this person a NABSE member in good standing? ❑ Yes ❑ No ❑ I don’t know
I am pleased to nominate the above person Name
Title
Company/Home Address City
State Zip
Telephone #
Signature
Return completed submission form by fax to (202) 608-6319 or by email to epotillo@nabse.org Attn: 2012 NABSE Awards Nomination Submission Deadline: August 31, 2012 NABSE NewsBriefs • W i n t e r 2 0 1 2
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