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CSHA District Awards Nomination Form 

Nominating colleagues and programs for recognition

CSHA has for many years recognized remarkable professionals and programs at both the district and state levels. That tradition will continue in person at Convergence 2024 in San Francisco! Please consider nominating an outstanding colleague or program for our 2024 Celebration of Excellence!

Deadline

Nominations for honors at both the district and state levels and are due to the CSHA office (honors@csha.org) no later than 11:59 p.m. on December 15, 2023. Nominations that don’t meet submission requirements, or arrive after the posted deadline, will not be considered out of fairness to others. The deadline will not be extended.

More information about the honors process, including nomination details, is available in the Board Governing Policies here. Please see District, State and National Honors, and Timeline starting on page 143 for details.

To view the elections and honors schedule, go here.

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Nominator First and Last Name

This digital name will be in lieu of a signature.

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Nominator Email Address
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Nominator Phone Number
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Nominee First and Last Name
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Nominee Email Address
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Nominee Mailing Address
Street Address, City, State, Zip Code
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Nominee Phone Number
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 Nominee CSHA Membership Status
Clear selection
Nominee Number of Continuous Years as a CSHA Member
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Other Awards Received by Nominee 
Write N/A if none.
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Roles and Offices Held in CSHA
Write N/A if none.
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Award for Nomination
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Written Narrative
Not exceed 300 words. Please describe why the nominee should be considered for the award based on the criteria in Board Governing Policy 9.8.
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Final Steps
Email two letters of support from CSHA members and nominee current CV or resume to honors@csha.org. The subject line must read "Nominee Name, Award for Nomination”. Emails without this subject line will not be considered. Thank you!
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