Regional EMS Award for Outstanding Contribution to EMS Emergency Preparedness and Response Nomination Form

Regional EMS Award for Outstanding Contribution to EMS Emergency Preparedness and Response NOMINATION FORM

  • Examples of programs meeting eligibility for this award would include; Disaster Response Teams, Community Emergency Response Teams, Continuity of Operations Planning, Mass Casualty Incident Training programs, all-hazards planning, emergency management partnerships and surge event planning. Eligible applicants include persons or entities developing or managing such programs.
  • 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.) Why does this program/accomplishment deserve to be recognized? (All-hazards planning, emergency management partnerships, work in emergency life cycle?) B.) Describe the demonstrated comprehensive and/or significant accomplishments/programs that contribute towards making their communities safer, stronger, better prepared and more resilient through emergency preparedness and response.
  • A.) Describe how the Mitigation, Preparedness, Response, Recovery objectives were met. B.) Provide examples and outcome measurements when possible. C.) Give detailed results analysis of the program.
  • Date Format: MM slash DD slash YYYY