Nomination Form: Community Activist Award
EXTENDED DEADLINE: October 2, 2023
SECTIONS IN THIS FORM:
Information About the Nominator
(name, email address, institution)
Information About the Nominee
(name, email address and/or URL to organization website)
FOR REFERENCE
Award descriptions & deadlines
Information About the Person Making the Nomination
Your Name
*
First Name
Last Name
Your Email
*
example@example.com
Your Institutional Affiliation
*
Nominations may be made by UAA members in the metropolitan area of the conference site as well as from members of the Local Host Committee. Which of the following best describes you?
*
I live and/or work in the New York metropolitan area.
I am on the Local Host Committee.
Information About the Nominee
Nominee Name
*
First Name
Last Name
Nominee Email (optional)
example@example.com
Link to Organization Website (optional)
Submit
Should be Empty: