IAIABC NextGen Award Nomination Form
The IAIABC NextGen Awards recognize talented leaders in the workers' compensation industry who are under the age of 40.
Nominator
Please share general information about the person submitting the nomination.
Nominator First Name
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Nominator Last Name
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Nominator Organization
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Nominator Job Title
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Nominator Email
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example@example.com
Nominator Phone Number
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Area Code
Phone Number
Nominee
Please share general information about the NextGen Award nominee.
Nominee First Name
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Nominee Last Name
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Nominee Organization
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Nominee Job Title
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Nominee Email
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example@example.com
Nominee Phone Number
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-
Area Code
Phone Number
Please confirm that the nominee will be under the age of 40 years old as of December 31, 2022.
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Please Select
Yes, the nominee will be under the age of 40.
The nominee works for a:
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Jurisdictional agency or government organization
Private sector organization
Insights
The information provided below will be the sole basis for the Selection Committee's NextGen Award decisions. Please be thoughtful in articulating what makes the individual rise above. The use of specific, objective metrics and examples of the individual's work as well as subjective rationale will be helpful for the selection process. This is a competitive award, so the more insights you can share, the better. See a sample nomination
What notable projects/programs has the nominee worked on within their organization? Please provide a description, the nominee's role, and results, if applicable. (250-400 words)
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What strengths and/or accomplishments has the nominee shown that have positively impacted their organization or the greater workers' compensation community? Please provide specific examples. (250-400 words)
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What qualities make the nominee stand out among their colleagues and/or peers? (100-250 words)
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Statement of Support
Please provide a statement of support for the nominee from someone other than the primary nominator. The statement should share why the supporter believes the nominee is deserving of an IAIABC NextGen Award.
Statement of Support First Name
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Statement of Support Last Name
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Statement of Support Organization
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Statement of Support Email
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example@example.com
Statement of Support (250-400 words)
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