Harriman Award Nomination Form

In This Section

W. Averell Harriman Award Nomination Form

Please note that a red asterisk indicates a field that must be filled or a question that must be answered in order for the form to be submitted.

Nominee Information

Nominee Name *

Nominee Grade *

Nominee Agency *

Nominee Position *

Nominee Post *

Nominee Email *

Nominee Phone

Nominee Address *

Nominee City *

Nominee State *

Nominee Zip Code *

Nominator Information

Nominator Name *

Nominator Grade *

Nominator Agency *

Nominator Position *

Association to Nominee *

Nominator Email *

Nominator Phone *

Nominator Address *

Nominator City *

Nominator State *

Nominator Zip Code *

Statement of Qualification *

In 700 words or less, please discuss the actions and qualities which qualify the nominee for this award. Please give specific examples of accomplishments that fulfill the criteria of the award, as described on this page. Submissions that do not meet the criteria as stated will not be considered.

Statement of Qualification *

Please Note:

If you do not hear back from AFSA by June 3 confirming your nomination was received, please email awards@afsa.org.

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Math question * 4 + 1 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.

Harriman Award Nomination Form

You are here

In This Section

W. Averell Harriman Award Nomination Form

Nominee Information

Nominator Information

In This Section