AC Committee: Colleague Nomination

ISOQOL Annual Conference Committee: Colleague Nomination Form

Thank you for your dedication to ISOQOL and for your involvement in the Annual Conference Committee and Co-Chair Nominations process. We greatly appreciate your suggestions and contributions to our organization. Please complete the form below to provide information about the colleague you wish to nominate to the best of your ability.
Your Contact Information
Nominator Name:

First NameLast Name
Nominator Email:
example@example.com
Indicate your nomination preferences below:
Nominee Contact Information
Nominee Name:

First NameLast Name
Nominee Email Address:
example@example.com
Nominee Current Employment/Company:
Nominee Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Reason for Nominating
In 250 words or less, please describe why you believe this individual should serve on the ISOQOL Annual Conference Committee.
Please select the committee position(s) you are nominating this individual for (select all that apply):
Should be Empty:

ISOQOL Annual Conference Committee: Colleague Nomination Form