2014 NCDS Awards Nomination Form

Please fill out and return to:
NCDS Awards Committee
1600 Evans Road
Cary, NC 27513

 

Category of Award:    ____________________________________________________________________________________________________________________

Name of Nominee:     ____________________________________________________________________________________________________________________

His/Her Address:       ____________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________________

 

Nominating Signatures:

1.  _______________________________________________________________        

2.  _______________________________________________________________

3.  _______________________________________________________________

4.  _______________________________________________________________

5.  _______________________________________________________________

6.  _______________________________________________________________

7.  _______________________________________________________________

8.  _______________________________________________________________

9.  _______________________________________________________________

10. _______________________________________________________________

 

Submitted by: 

Name:  _______________________________________________________________________________________________________________________________

Date:   _______________________________________________________________________________________________________________________________    

Telephone(s):  _________________________________________________________________________________________________________________________

 

* Please attach typewritten sheets giving resume of nominee's qualifications for this award and include a brief statement of why this person deserves to be considered for this award.

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