Carol Baffi-Dugan Service Award 2018 Nomination Form
The Carol Baffi-Dugan Award for Service was established in honor of a long-term NAAHP leader who, through her selfless commitment to both her Regional Association and NAAHP, has set an example of dedicated service for all to follow. This award will recognize one member of each Regional Association who exemplifies these qualities through their service to both NAAHP and their regional association. Awards will be presented during the opening plenary at the National Meeting.

The form below is for the nomination of candidates for selection by the region for this award. Nominations will open on February 1 and each region will set a deadline for receipt of nominations.. Each region will choose one individual to send forward as the regional recipient. Please note: Regional or National Board of Directors members are not eligible for this award while currently serving.

Please complete the first part of the form about the candidate and the second part of the form with your information.


National Association of Advisors for the Health Professions
NAAHP
Candidate Information
Last Name *
Your answer
First Name *
Your answer
Institution *
Your answer
Current Position (Please indicate faculty status if applicable.) *
Your answer
Service To Regional Organization *
Please provide in bulleted list format
Your answer
Service to National Organization *
Please provide in bulleted list format
Your answer
Other Relevant Information *
Please include any additional information that you believe is relevant
Your answer
Nominator Information
How do you know the Candidate? *
Your answer
First Name *
Your answer
Last Name *
Your answer
Institution *
Your answer
Email *
Your answer
Current Position (Please indicate faculty status if applicable.) *
Your answer
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