Please complete this brief nomination form. You will need to complete a separate nomination form for each candidate that you are nominating. All nominations must be received by Friday, February 22, 2019 at 5 PM ET.

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* 1. Please enter the name of the person you are nominating for a Board position:

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* 2. Which position are you nominating this person for?

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* 3. Please provide any additional information (nominee's past service to SMDM, letter of support, etc.) to help the committee's deliberations:

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* 4. Nominator's Name

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* 5. Nominator's E-Mail Address

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