2019 Instructor of the Year Nomination
Members can use this form to nominate others for the 2019 EMS Instructor of the Year. The submission deadline is January 31, 2020. The award will be presented at the Spring Conference, March 5 -8, 2020 in Traverse City Michigan.

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Your Name *
Please enter your first and last name.
Your answer
Your Email Address *
Please provide the email that is associated with your SMEMSIC membership.
Your answer
Name of Nominee *
Please enter the first and last name.
Your answer
Email Address of Nominee *
Your answer
Describe the personal continuing education activities undertaken by the nominee to prepare for the optimal education of others.
Your answer
Describe the nominee's activities directly related to the education of EMS personnel.
Your answer
Describe the nominee's community service activities NOT directly related to EMS.
Your answer
Provide at least two examples of the nominee's effort to promote public awareness of EMS through education.
Your answer
Explain why you believe the nominee should receive this award.
Your answer
Provide any additional supporting comments.
Your answer
Please email two letters of support from two other ICs for this nomination to admin@smemsic.org . *
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