Carl Fleischhauer Award Nomination Form
Please complete all sections to nominate a candidate. All fields are required.
PROPOSER
Proposer's full name
*
Proposer's affiliation
*
Proposer's email address
*
example@example.com
Re-type email address
*
example@example.com
I PROPOSE THE FOLLOWING CANDIDATE
Candidate's full name
*
Candidate's affiliation
*
Candidate's email address
*
example@example.com
Brief bio
*
Benefits to the TC
*
Submit
Should be Empty: