19-20 NC HOSA Awards Nomination Form
NC HOSA annually recognizes those individuals or groups who have made outstanding
contributions to North Carolina HOSA. Chapters should submit a completed nomination form
to NC HOSA prior to the conference registration deadline. If you have questions, please
contact Katrina Coggins.

Honorary Life Member - Given to an individual who has made a long-term contribution to NC
HOSA, and who is deserving of a high honor.

VIP Award - Given to a person in an educational administration position who has demonstrated
outstanding support of NC HOSA, i.e. CTE Directors, Superintendents, Principals, Legislators,
Mayors, etc.

Partnership Award - Given to a person or organization outside of NC HOSA, based on their
contribution to NC HOSA in strengthening the partnership of supporting our future health
professionals, i.e. hospitals, health agencies, healthcare organizations, businesses, local and
state agencies, etc.

Merit Award - Given to a person within the HOSA organization or working with the
organization who deserves recognition for his/her special efforts, i.e. advisors, retired advisors,
alumni, national officers, parents, spouses, etc.
Email address *
Chapter submitting the nomination (spell out the chapter name - no abbreviations please) *
Your answer
Advisor Name *
Your answer
Nominee *
Your answer
Nominee Title *
Your answer
Nominee Organization *
Your answer
Award you are nominating the person to receive *
Describe the nominee's contributions to NC HOSA. Include specific details and dates of involvement. *
Your answer
Provide any additional information about the person or organization.
Your answer
A copy of your responses will be emailed to the address you provided.
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