iNEER Award Nomination Dossier

Nominator Information:

Name:

Title:

Affiliation:

Address:

Email address:

Telephone:

Fax:

Nominee Information:

Name:

Title:

Affiliation:

Address:

Email address:

Telephone:

Fax:

Category of Award:

Suggested Citation (15 words or less):

Will Nominee Be Present at Awards Ceremony?:

Summary of Accomplishments:

Include Letters of Support Here

Include Curriculum Vitae of Nominee Here