WEPAN Awards Nomination

Award Category*
Name of Nominee, Program, or Organization*
Nominee Institution or Organization*
Nominee Position (Exact Title)*
Nominee Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Nominee Email*
example@example.com
Nominee Phone Number*
Please enter a valid phone number.

Nominator Information
Name of Nominator*

First NameLast Name
Nominator Institution or Organization*
Nominator Position (Exact Title)*
Nominator Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Nominator Email*
example@example.com
Nominator Phone Number*
Please enter a valid phone number.

Nomination Rationale

A statement, not to exceed 500 words, describing the nominee's major qualifications for the award and supporting the strength of these qualifications.
Nomination Statement*

0/500

Document Uploads
Please upload recommendation letters and other nomination materials below.

You may also send them to info@wepan.org. Please include on the subject line: “WEPAN Awards nomination for (name of nominee)." If sending via email, please send the entire package in one email.
File Upload

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