2022 Allen Hager Legislative Award Nomination Form

2022 Allen Hager Legislative Award Nomination Form
Nomination Deadline: August 12, 2022

* Indicates required field

Nominator Name *

First

Last

Nominator Email *

Nominee Name *

First

Last

Nominee Email *

Agency Name *

Agency Address *

Address 2 *

City *

State *

Zip *

Phone Number *

Years as HCAOA Member *

Does the nominee demonstrate exceptional leadership skills by serving on a national committee/task force, Board of Directors or a Chapter officer? *

What capacity does the nominee serve the HCAOA? *

How does the nominee exhibit a high degree of professionalism, competence and integrity in serving the chapter/association? *

Does the nominee actively work with other members to establish common ground, consensus and a united voice on issues? *

Describe the nominees experience in meeting with lawmakers to educate and garner their support on proposed legislation. *

Submit Nomination