Regional EMS Award for Outstanding EMS Leadership Nomination Form

Regional EMS Award for Outstanding EMS Leadership 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 individual demonstrated an ability to organize, conduct, manage, problem solve and evaluate within his or her organization? B.) How has this individual, through exemplary leadership and administrative skills, improved the effectiveness, response and delivery of EMS?
  • A.) How has this nominee enhanced EMS for their agency, region or the state? B.) Does this Leader sit on any committees or participate with programs that help to further enhance EMS and patient care?
  • Date Format: MM slash DD slash YYYY