ANCBH: Association of North Carolina Boards of Health
ANCBH: Association of North Carolina Boards of Health

Phone: (704) 300-1365
(ans. mach.)

General E-mail: ancbh@ancbh.org

Surface Mail and Shipping:
Association of North Carolina Boards of Health
Box 974
Boiling Springs, NC 28017

Award Nomination Form

For every nomination:

  • Please provide specific examples for each of the five criteria in your nominations
  • Please attach up to two double-spaced typed pages describing the justification for the awards
  • You may also enclose up to two letters of endorsement
  • Send completed forms and supporting documents to: Robert Blackburn, Box 974, Boiling Springs, NC  28017
    Email: rblackburn1@carolina.rr.com
    FAX: Please call 919.403.8182 before faxing any material
    For more information, please contact Robert Blackburn directly at 704.434.7926

If you would like to nominate more than one person or group for awards, please copy the form in this issue and complete one form for each nomination.

The deadline for 2011 nominations will be January 6, 2012.

View/Download Award Nomination Form (PDF)