CTN AWARDS 2021-2022

Question Title

* 1. Please list the name of the person you are nominating. 

Question Title

* 2. List the name of the organization where the nominee works.

Question Title

* 3. Please provide a valid email or phone number of the person you are nominating. 

Question Title

* 4. If your nominee works at a Trauma Center, please select which level Trauma Center below. If your nominee does not work at a Trauma Center, please select other.

Question Title

* 5. Please choose the correct award category for your nominee below. 

Question Title

* 6. In a few sentences, using the awards criteria, please tell us why you are nominating this person and what impact they have created in trauma care?  Further below, question 9, you will have the opportunity to attach any other supporting documents to support this nomination. Find the Awards Criteria on the CTN website here

Question Title

* 7. Is there anything else you would like the Awards Committee to know about your nominee?

Question Title

* 8. Please provide your name and contact info in case we have questions

Question Title

* 9. Supporting documents

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File
0 of 9 answered
 

T