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NYSSOS Advocate of the Year Nomination Form

Recommended award criteria include:

  • Active in state society legislative efforts
  • Involved in NYSSOS calls and action alerts
  • Attended NYSSOS Annual Advocacy Day or other policy conferences
  • Visited with state legislators regarding issues affecting the specialty
  • Participated in legislative review and legislator outreach on behalf of the society society
  • Called state and federal legislators to weigh-in on key issues
  • Contacted the governor's office regarding issues related to the society
1.Nominator Information
2.Relation to Nominee
3.Nominee Information
4.Is the Nominee a NYSSOS Member?
5.To the best of your knowledge has the nominee:
Yes
No
 Visited with state or federal lawmakers to discuss issues affecting the specialty?                                                                             
Called or emailed state and federal legislators to weigh in on key issues?                       
Participated in legislative review and analysis on behalf of society?                                                                                             
Authored or co-authored bill language at the state level on issues affecting the specialty?                                                                                         
6.The nominee has participated in other grassroots activities:
7.Briefly explain why you recommend the nominee for the award.
8.You are welcome to upload any additional documents to support the nomination
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