Medallion Nomination - 2023

AFGC 2023 Medallion Nomination Form
Deadline: November 1, 2022

 


Nominee's Name:
Nominee's State Council Affiliation:
Nominee's Title:
Nominee's Mailing Address:
Nominee's Telephone Number:
Nominee's Email Address:
Nominee's Academic History:
Nominee's Employment History :
Nominee's Prominent Honors, Awards, or Other Recognitions Received:
Please tell us why you feel this person is deserving of this award.:
Nominee's involvement in professional organizations and/or major activities. These do not need to be industry specific.:
Nominee's Publications and/or Presentations:
Nominee's Contributions to AFGC:
Please upload a bio for the Nominee in paragraph format. This will be used to recognize nominee.:
(Valid File Types: bmp,csv,doc,docx,eps,gif,jpeg,jpg,mfp,pdf,png,ppt,pptx,rft,swf,tif,txt,xls,xlsx | Maximum File Size : 1.0 MB)
Please upload a photograph of the Nominee.:
(Valid File Types: bmp,csv,doc,docx,eps,gif,jpeg,jpg,mfp,pdf,png,ppt,pptx,rft,swf,tif,txt,xls,xlsx | Maximum File Size : 1.0 MB)
Nominator's Name:
Nominator's Telephone Number:
Nominator's Email Address:
By entering my name below, I acknowledge that the content in this form is accurate to the best of my knowledge. :




AFGC  
PO Box 867, Berea, KY 40403
800-944-2342
tina@afgc.org
www.afgc.org