Hall of Fame Lifetime Achievement Award Nomination Form

To complete a submission for the NCSHRM Hall of Fame Lifetime Achievement Award, please complete all fields of the form below.

Nominee Name(Required)

First Last

Job Title(Required)

Employer's Name(Required)

Employer Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Nominee's Email Address(Required)

Nominee's Phone Number(Required)

Nominee's Chapter Affiliation(Required)

Nominated by:(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Nominee is or has been employed or primarily conducts business in the state of North Carolina(Required)

Yes

Nominee is or has been employed as an HR Professional for at least 20 years, including current and past employers, years of service and position(s) held(Required)

Yes

Summarize why this individual is deserving of this lifetime achievement award.(Required)

Please complete the information to the best of your knowledge. Please note that awards co-chairs may reach out to you for additional information as needed during the selection process.

Summarize the receipients service to the HR profesional: i.e. leadership and service in advancing the quality of human resource services and the profession of human resource management.(Required)

List the recipients credentials: i.e. professional degrees or certifications received in relation to one or more of the various aspects of human resources.(Required)

Summarize the recipients leadership in the business community: i.e. involvement beyond the scope of their employment including development, sponsorship, or promotion of the HR profession within the community or state.(Required)

Summarize the recipient's service to the civic community: i.e. significant honors and accomplishments (other than human resources related) that can be documented to show leadership and service to the nominee's community and state.(Required)

List the recipients previous awards and recognition: Do they support the above categories? i.e. honors received, offices held in organizations, published research and/or articles, and teaching/training activities in the community.

List any additional comments regarding the nominated individual:

Hall of Fame Lifetime Achievement Award Nomination Form

Hall of Fame Lifetime Achievement Award Nomination Form

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