Exit this survey >>
2010 AHVRP Award for Excellence
1. Award for Excellence 2010
All submissions will be reviewed and evaluated by the AHVRP Board of Directors according to established criteria. Please be sure you have carefully reviewed the purpose, eligibility, and criteria for this distinguished award. Selection is based solely on the information provided - please be comprehensive. All entries must be submitted by June 8, 2010.
1
. Please complete the following demographic information:
Please complete the following demographic information:
Nominee's Full Name:
Nominee's Title:
Facility Name:
Facility Address:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP:
Email Address:
Phone Number:
2
. Please complete the following demographic information:
Please complete the following demographic information:
Submitted by (Full Name):
Title:
Facility Name:
Facility Address:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP:
Email Address:
Phone Number:
*
3
. Please enter the number of years the nominee has been a regular AHVRP member.
Please enter the number of years the nominee has been a regular AHVRP member.
*
4
. Please expound: Leadership role in advancing the practice of healthcare volunteer management.
Please expound: Leadership role in advancing the practice of healthcare volunteer management.
*
5
. Please expound: Responsibility for major contributions to the advancement of the profession of volunteer management through leadership innovations, implementation of new programs, management, initiatives, authorship, teaching, research in healthcare volunteer management, etc.
Please expound: Responsibility for major contributions to the advancement of the profession of volunteer management through leadership innovations, implementation of new programs, management, initiatives, authorship, teaching, research in healthcare volunteer management, etc.
*
6
. Please expound: Active participation in AHVRP, e.g., service on the Board of Directors, committees, subcommittees and such focused activities as presenter, author, etc.:
Please expound: Active participation in AHVRP, e.g., service on the Board of Directors, committees, subcommittees and such focused activities as presenter, author, etc.:
*
7
. Please expound: Active participation in local, regional or state Affiliated Group and volunteer management organizations:
Please expound: Active participation in local, regional or state Affiliated Group and volunteer management organizations:
Javascript is required for this site to function, please enable.