Nomination Application

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.

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Nominee's Demographic Information

Please fill-in the following information for the person that you are nominating.

Name

First

Last

Organization

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

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.