2012 William S. O'Farrell Volunteer Award Nomination
 

The purpose of the William S. O'Farrell Award is to recognize significant contributions to AMIA and to the field. Nominees for the Award must have made a significant contribution to AMIA, either in the form of notable achievement or special projects, or through the noteworthy performance of volunteer work carried out over a long period of time.

*
Name of Nominee

*
Nominee's Employer/Institution

Nominee's email address

*
Statement of nomination - in what ways has this candidate made a significant contribution to AMIA, either in the form of notable achievement or special projects, or through the performance of volunteer work carried out over a long period of time? The statement of nomination will be used by the Committee and included in any written announcement for the honoree.

Additional comments about the Nominee or Nomination.

*
The Awards Committee may wish to contact you for further information about this nomination. Please provide us with your contact information:

*
If not chosen for this year's award, please keep this nomination for consideration next year ...