If nominating an agency, please include the agency license number here.
a.) Describe how this person’s dedication and service has demonstrated an exceptional contribution; improved delivery of emergency medical services in the local, regional, state and national EMS system.
b.) Are there any programs or events that they have implemented or educational programs that they have created or enhanced?
c.) Does this nominee provide any other volunteer or career services within the EMS system at the local, regional, state and national level?
a. Does this nominee serve on any committees or participate with any groups that help to enhance and advocate for EMS and/or telecommunications at the local, regional, state and national level?
Accepted file types: jpg, jpeg, png, gif.