Regional EMS Award for Excellence in EMS Nomination Form

Regional EMS Award for Excellence in EMS NOMINATION FORM

  • Read each statement below carefully and answer completely. Limit documentation to the information requested. Up to three documents may be attached to the nomination form. Of these items, one letter of support written by someone other than nominator must be included. Other documents may include a resume or CV, a newspaper article written about the nominee, etc.
  • Drop files here or
  • A.) How has this person/program/agency exemplified outstanding dedication and service to the statewide Virginia emergency medical services system? B.) Why is this nominee exceptionally qualified and selected for this award? C.) How has this person/program/agency demonstrated a commitment to a comprehensive, integrated system of emergency medical services throughout the Commonwealth?
  • Date Format: MM slash DD slash YYYY