Nomination Form for Apra Indiana Service Award
The Apra Indiana Service Award is designed to recognize a member of the prospect research community who has demonstrated leadership, dedication, and commitment to the field. If you know of a current or previous member who has demonstrated these qualities, please submit a nomination form. A group of individuals may complete the form.

Previous winners of this award are:
Susan O'Shea, Purdue University (2017)
Karen McTague, Second Harvest Food Bank (2016)
Ralph Rohrer, Purdue Foundation (2013)
Karen Anderson, University of Notre Dame
Michele Miller, Butler University (2006)
Barbara Lee, Butler University (2000)
Betsy Schmidt, Franklin College (1997)

Nominations must be submitted by September 28, 2019.
Name of Nominee: *
Nominee works for: *
Nominee's email: *
Nominee's Supervisor's name (if known):
Organization or Supervisor's phone number (if known):
Individual(s) nominating the nominee - include name and phone number for each individual *
Is the nominee an active member of Apra Indiana for 2019? *
If the nominee is not an active member, what was the approximate last year he/she was active?
Please share why you believe this person is deserving of this award, and how the nominee has demonstrated leadership, dedication, and commitment to the field. *
Please explain the nominee's service to Apra Indiana or International. For example, did they serve on a committee, participate on the board, and/or present at an event? Please list the roles and approximate dates of service below. *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy