Award Nomination Form

scholarship

Award Nomination Form


    To find out more about the awards click here

  • Select Award:
    (You may select up to 3 awards):













Nominee Information:

  • Nominee's Last Name:*
  • Nominee's First Name: *
  • Nominee's Position/Title: *
  • Nominee's Organization: *
  • Nominee's Mailing Address 1: *
  • Nominee's Mailing Address 2:
  • Nominee's City: *
  • Nominee's State: *
  • Nominee's Postal Code: *
  • Nominee's Country:*
  • Nominee's Phone No:*
  • Nominee's Email Address: *

Point of Contact for this Nomination:   Same contact info as above (use if self-nominating)

  • Point of Contact Name: *
  • Point of Contact Title: *
  • Point of Contact Mailing Address 1: *
  • Point of Contact Mailing Address 2:
  • Point of Contact City: *
  • Point of Contact State: *
  • Point of Contact Postal Code: *
  • Point of Contact Country:*
  • Point of Contact Phone No: *
  • Point of Contact Email Address: *

Nomination Information:

  • Nomination Summary (Less than 300 words, upload supporting documentation down below.):*
  • Nominee’s Participation in Other Activities/Organizations:
  • Additional Information to Share about your Nominee
  • Tell us about yourself: *

Upload Supporting Documents

The picture should be 300 dpi (print-ready), high-resolution, JPG preferred, but EPS or PNG accepted

  • Upload Picture 1:
  • Upload Picture 2:
  • Upload Picture 3:
  • Upload Document 1:
  • Upload Document 2:
  • Upload Document 3:

Award Nomination Process

Nominations for all awards shall be submitted to the Awards Committee prior to July 15th of each year. Nominations should include, but are not limited to the following:

  • Nominee’s name, organization, mailing address, phone number, email address, name of the award person is being nominated for, point of contact if nominee is selected for an award (include mailing address, email address and phone number), and other pertinent data. For group/business awards, list names of the principal participants in the group/business.
  • A short (one paragraph) summary indicating why the individual or group/business is deserving of the award.
  • Specific justification for the award citing examples and detailed support for information. The justification should be limited to no more than two pages.
  • Any significant and appropriate extra-curricular activities or organizations in which the nominee has participated.
  • Name of the person submitting the nomination and the nomination date.

If you have any query please email to Paul.planzer@atca.org

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