2019 Member of the Year Nomination Form
NIEAPA chapter members have the opportunity to nominate a fellow active chapter member in good standing for the honor of Member of the Year. Please name a person who you believe deserves to be recognized for his or her outstanding service to the chapter and to the field of employee assistance. The Awards Committee, which is comprised of the previous winners, will review the candidates' qualifications and select the winner. The Member of the Year will receive the award during the luncheon at the NIEAPA Annual Conference on Tuesday, June 4, 2019.

Please include in your written description:
1.) The reasons your nominee qualifies for this award.
2.) Specific information about the person's character and contributions to the Chapter and to the field of Employee Assistance.

The deadline for submissions is Friday, April 26, 2019

Name of Candidate *
Your answer
The reasons your nominee qualifies for this award *
Be as specific as possible
Your answer
Your Name *
Your answer
Email *
Your answer
Phone Number *
Your answer
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