FWATA Honors and Awards Committee                  Initial Consideration for Nomination Form (2022-2023)
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 FWATA Honors and Awards Committee.
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Candidate Name (Last, First) *
Title of Candidate *
Candidate Current Employer *
Candidate Phone Number *
Candidate Email *
Award Being Nominated For: *
Meets the Minimum Qualifications for Award *
Years of Service as an Active Certified Member *
Previous FWATA, NATA or State Award(s) Received by Candidate *
Required
Please quickly explain why this candidate deserves this award. *
Have you contacted the candidate to inform them of the submission of this nomination? *
Nominator Name (Last, First) *
Title of Nominator *
Nominator Current Employer *
Nominator Phone Number *
Nominator Email *
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 of February 15. *
Date *
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