Nominator's Contact Information

Nominator's First and Last Name:

Nominator's Email:

Nominator's Phone Number:

Nominee's Information

Nominee's First and Last Name:

Nominee's Email:

Nominee's Phone Number:

Nominee's Title/Position:

Nominee's School/Company/Organization:

Have you communcated directly to your nominee and has he/she agreed to be nominated?
 Yes, they have
 No, I have not and understand he/she cannot be nominated

Why does this person deserve this award or recognition? Please limit your response to 300 words.