AWARDS PACKET
2024

Nominee Information

Nominator Information

Questionnaire

Describe the impact that the nominee has had on the EMS profession while serving in the role that is related to the awards for which you are nominating them. Be as specific as possible.
Describe any characteristics of the nominee that have distinguished them from their peers.
Involvement in EMS-Related Organizations

Local, state, and national level EMS-related organization nominee belongs or has belonged to, and leadership level attained by the nominee.  List the date(s), name(s) of the organization(s), the nominee belongs to, rank attained (member, officer, Board of Directors)

EMS Related Award

Support For This Nomination

Please list any other people that are joining you in submitting this nomination.  Make sure they have agreed to be contacted by the Awards Committee before including them on this application. 
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You must submit the nomination package to:
LANREMT AWARDS COMMITEE
by May 17, 2024
Press the submit button to submit your application.

Awards_Chairperson@lanremt.com