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: Lorraine S. Salois-Deane, MBA, MSPH, 3420 Ridge Road, Durham, NC 27705-5538.
Email: lsalois-deane@nc.rr.com.
FAX: Please call 919.403.8182 before faxing any material.
For more information, please contact Lorraine Salois-Deane directly at 919.403.8182.
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 2007 nominations will be January 15, 2008.