NAGARA 2023 Annual Awards Program Nominations Form

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* **Nominee's Name and Basic Contact Information (required):**

Full Name

Organization/Agency

Email Address

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* Nominee's Demographic Information (optional):

Level of Government

Region

Birth Year

Race

Gender

Pronouns

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* Nominator's Name and Basic Contact Information (If different than the nominee above):

Full Name

Organization/Agency

Email Address

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* For which award are you nominating this individual/program (Please select one)

NAGARA Program Excellence Award

Bruce W. Dearstyne Distinguished Service Award

READI Award

Emerging Leader Award

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* Please include a brief 200 word or less abstract summarizing your nomination:

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* Please include a narrative statement of 500 – 1500 words indicating with more detail why this person/program should receive the selected award:

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* Endorsement letters, news articles, and other supporting documentation may also be submitted along with this nomination. Only PDF, DOC, DOCX, PNG, JPG, JPEG, GIF files are supported, each limited to 16MB.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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* Additional Attachments (if desired)

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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* Additional Attachments (if desired)

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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* Additional Attachments (if desired)

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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* Additional Attachments (if desired)

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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* Additional Attachments (if desired)

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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* Additional Attachments (if desired)

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.