Individual Achievement Award Nomination Form

Eligibility

ISHMPR member in good standing
10 or more years experience in planning, marketing, or public relations/communications, including at least five years of direct involvement in the healthcare industry.

Nominee's Demographic Information
Please fill-in the following information for the person that you are nominating.
Name*
First Last
Organization*
Phone*
Email*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Nomination
Nominee Personifies*
Please describe how the nominee personifies each award criteria: Proven innovation in public relations or marketing, Enhancement of the healthcare marketing/public relations profession, Personal qualities and leadership abilities, and Community service/civic achievement. (max. 250 words)
ISHMPR Involvement*
Please share how the nominee has participated in or contributes to the enhancement of ISHMPR. (max. 250 words)
Endorsement*
Share why you feel the nominee deserves to receive the award. (max. 250 words)
Nomination Submitted By
Please fill-in information about yourself below.
Name*
First Last
Organization*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Are you an ISHMPR Member?*