VATA HONORS AND AWARDS NOMINATION FORM

VATA HONORS AND AWARDS NOMINATION FORM
This form will be used to do a pre-screen of all Candidates to ensure that they meet the minimum qualifications and are eligible for the specific award. Once eligibility has been determined, the Nominator will be notified. Additionally, the Candidate will be contacted to move forward with completing and submitting a full application packet to the VATA Honors and Awards Committee.
Candidate Name (last, first)*
Nominator Name (last, first)*
Title of Candidate*
Title of Nominator*
Are you (nominator) a VATA member?

YESNO
Candidate Current Employer*
Nominator Current Employer*
Candidate Phone Number*
Nominator Phone Number*
Candidate Email*
Nominator Email*
Award Being Nominated For*
Explain Why this Candidate Deserves this Award*
By typing my name below, I understand, as the Nominator, that this form is merely for pre-screening purposes and that the Candidate will need to submit a full Honors and Awards Application Packet to be considered for the award prior to the submission due date.*
Should be Empty: