Online Nomination Form

Date of Nomination

First name and last initial

Email *

Nominated by (ONLY for RCMs)

Nominated by (ONLY for VRSC Trusted Servants)

subcommittee for Area

Nominated by (ONLY for VRC, Ad Hoc Chairs, & Task Force Chairs - type in the name of your subcommittee or task force)

Second by (Please type in their first name and last initial)

Second by (Please ALSO select Area of the 2nd - only RCMs can 2nd a nomination)

Nominee's first name and last initial

Position nominated for