Spring Travel Award Nomination Form

Region II Travel Award

2015 Spring Meeting in Baltimore, MD, April 26-29, 2015

Rules and Guidelines

Nominations are due March 6, 2015.

The Microsoft Word version of the nomination form may be accessed here, with a completed packet sent to Brian Squilla.

(For the Annual Meeting award form, please click here.)

 

    Nominee information

    Name:
    Title:
    Department:
    Organization:
    Address:
    Telephone:
    Email:
    Time in position:

    Individual making the nomination

    (self-nominations are permitted)

    Name:
    Title:
    Department:
    Organization:
    Address:
    Telephone:
    Email:

    Letter of Support from supervisor

    Name:
    Title:
    Department:
    Organization:
    Attach Letter of Support

    Description of nominee's current responsibilities.

    Describe how this award will benefit the nominee.

    Describe how this award will benefit his/her institution.