NJHC Awards & Prizes Nomination Form
Contact: niquole.primiani@sos.nj.gov, 609-943-3307
Nominee Name
*
First Name
Last Name
Nominee Title
*
Nominee Professional Affiliation
*
Nominee Email Address
*
example@example.com
Nominee Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is this a self-nomination? (Self-nomination requires 2 references.(FOR HUGHES, AWARD OF RECOGNITION, GARVIN and DRISCOLL PRIZE.)
Yes
No
Reference #1
First Name
Last Name
Title (if applicable)
Professional Affiliation
Email
example@example.com
Phone Number
Please enter a valid phone number.
Reference #2
First Name
Last Name
Title (if applicable)
Professional Affiliation
Email
example@example.com
Phone Number
Please enter a valid phone number.
Award or Prize
*
Richard J. Hughes Award
Awards of Recognition
Mildred Barry Garvin Prize
Alfred E. Driscoll Prize
FOR HUGHES, AWARD OF RECOGNITION & GARVIN PRIZE (Not required for Driscoll.) Why does the nominee deserve this award or prize? (500 words maximum)
0/500
FOR HUGHES, AWARD OF RECOGNITION & GARVIN PRIZE (Not required for Driscoll.) Nominee's curriculum vitae (3 pages maximum)
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FOR GARVIN PRIZE ONLY - curriculum materials
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FOR DRISCOLL PRIZE ONLY - Email a digital copy of the dissertation to niquole.primiani@sos.nj.gov
REQUIRED FOR ALL NOMINATIONS Nominator Name
*
First Name
Last Name
Nominator Email Address
*
example@example.com
Nominator Title (if applicable)
*
Nominator Professional Affiliation
*
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