NOMINATION FORM
Please nominate a frontline healthcare worker by filling out information requested. Please follow guidance below  before you  nominate a frontline health care worker . 1) One nomination per form only 2) Only frontline COVID-19 frontline healthcare workers can be nominated.Check our website for updates on this campaign: globalstudytreks.org.
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                                         *HELPING HEAL COVID -19 FRONTLINE WARRIORS *
Name (of frontline healthcare worker)
Where does the healthcare worker work?(Name of healthcare institution/hospital/nursing home etc )
Contact Information of healthcare worker (Address,email and cellphone number)
Why do you wish to nominate this frontline healthcare worker in particular? How in your opinion did this frontline worker go above & beyond ?Please explain clearly with examples
Are you related to the frontline healthcare worker you recommended?
Did you submit a picture (required in order to complete this nomination) of the healthcare worker you are nominating to :globalstudytreks@gmail.com
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YOUR name,address & contact information ( email and cell phone)
Thank you for nominating a frontline healthcare worker.Please visit our website:globalstudytreks.org for up to date news on nomination process
A copy of your responses will be emailed to the address you provided.
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