Arizona Department of Health Services
Emergency Medical Care Technician of the Year Award Nominations

The Arizona Department of Health Service's 2024 EMCT of the Year Awards recognize outstanding Emergency Medical Care Technicians across Arizona who have gone above and beyond to serve their communities.

Please use this form to nominate an EMCT who has demonstrated a commitment to serving their community, including the following criteria:

Years of service
Academic advancement achievements
Meritorious service awards by agency or community
Community volunteer service
Other achievements or contributions

All nominations must be submitted for review by March 15, 2024 at 5:00 p.m. for consideration.

Nominations will be reviewed by each participating EMS Regional Council and Arizona Department of Health Services with the goal of one (1) EMCT of the Year Award per region.

The EMCT of the Year Awards will be presented at the EMS Council Meeting on May 16, 2024.

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* 1. Name of nominee:

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* 2. Phone number of nominee:

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* 3. Email address of nominee:

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* 4. Employer / Organizational affiliation of nominee:

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* 5. Which region does the EMCT primarily work in? (Please select one option only to indicate the EMCT's primary service area. This information is required for the EMS regional council that oversees the service area that the EMCT covers to be able to review the nomination.)

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* 6. Years of service by the nominee:

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* 7. Please describe any academic advancement achievements of the nominee:

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* 8. Please describe any meritorious service awards received by the nominee from their agency or community:

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* 9. Please describe any community volunteer service of this nominee:

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* 10. Please describe any other achievements or contributions of this nominee for consideration:

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* 11. Name of person submitting this nomination
(if any follow-up information is needed):

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* 12. Phone number of nominator
(if any follow-up information is needed):

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* 13. Email address of nominator
(if any follow-up information is needed):

Arizona Department of Health ServicesEmergency Medical Care Technician of the Year Award Nominations

Question Title

* 1. Name of nominee:

Question Title

* 2. Phone number of nominee:

Question Title

* 3. Email address of nominee:

Question Title

* 4. Employer / Organizational affiliation of nominee:

Question Title

* 5. Which region does the EMCT primarily work in? (Please select one option only to indicate the EMCT's primary service area. This information is required for the EMS regional council that oversees the service area that the EMCT covers to be able to review the nomination.)

Question Title

* 6. Years of service by the nominee:

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* 7. Please describe any academic advancement achievements of the nominee:

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* 8. Please describe any meritorious service awards received by the nominee from their agency or community:

Question Title

* 9. Please describe any community volunteer service of this nominee:

Question Title

* 10. Please describe any other achievements or contributions of this nominee for consideration:

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* 11. Name of person submitting this nomination (if any follow-up information is needed):

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* 12. Phone number of nominator (if any follow-up information is needed):

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* 13. Email address of nominator(if any follow-up information is needed):

Arizona Department of Health Services
Emergency Medical Care Technician of the Year Award Nominations

* 11. Name of person submitting this nomination
(if any follow-up information is needed):

* 12. Phone number of nominator
(if any follow-up information is needed):

* 13. Email address of nominator
(if any follow-up information is needed):