Humanitarian Award Form

NCSHRM Humanitarian Award Nomination Form

To complete a submission for the NCSHRM Humanitarian 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

Provide a detailed explanation as to why the individual is deserving of the award. How has the nominee been involved with improving his/her community? How has the nominee gone about engaging others in the community?(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.

Awards and Recognition: i.e. honors/accolades received for work within the community

Any additional comments regarding the nominated individual:

Humanitarian Award Form

NCSHRM Humanitarian Award Nomination Form

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