Nominee Information
Full Name of Nominee
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First Name
Last Name
Organization Affiliation
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Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Cell:
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Please enter a valid phone number.
Format: (000) 000-0000.
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
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example@example.com
Description
1. Describe nominee’s wildfire resiliency advocacy efforts.
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2. What makes this nominee a trailblazer in wildfire resiliency? Please give examples of innovation and activities that makes this individual outstanding and unique.
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3. Describe the results of the nominee’s wildfire resiliency efforts and how they have impacted their communities.
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4. How does Lynn Orstad’s story resonate with the nominee?
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5. Include two letters of support for this award from nominee’s superiors and/or community leaders. List the references here and attach the letters as a separate file below.
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6. List the nominee’s membership or participation in any wildfire resiliency conferences, workshops or trainings, and task forces.
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7. List any other awards received.
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8. Please include any additional information to support why the nominee should be considered for the Lynn Orstad: Women in Wildfire Resiliency Award.
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To be completed by person submitting nomination (if different from above)
Full Name
*
First Name
Last Name
Organization Affiliation
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Cell
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Submit
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