2019 Award Nomination Form
All nominations must be submitted by Feb. 15, 2019. If your nomination is selected, you will be contacted the first week in March. The awards presentation is planned for 6:30 p.m. March 28 at Hilton Garden Inn, Johnston. Questions? Contact Connie Johnson, cjohnson@plaea.org.
Email address *
I'd like to nominate...
Your answer
Where does the nominee work?
Your answer
This nomination is for
Please select one award category:
Please tell us why you feel this individual or organization should receive this award.
Your answer
Contact information for the nominee.
Can be email, cell phone, Twitter handle, etc.
Your answer
My name is...
Your answer
You can contact me at...
Your answer
Please indicate below if you wish to remain publicly anonymous. By clicking 'yes', your name will not be associated with the nomination. By clicking 'no', we will share your name with the person or organization you're nominating and may include it in the script during the awards ceremony.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Prairie Lakes AEA. Report Abuse - Terms of Service