** Denotes required fields.

Date:**

1st Nominator Name: **

E-mail: **

Affiliate: **

2nd Nominator Name: **

E-mail: **

Affiliate: **


As voting members of the NENA, we nominate:

Nominee Name:**

For the position of: **

Nominee is a NENA Member in good standing.Yes

The Nominee accepts the nomination.Yes

Attach Nominee CV (pdf only). NOTE: the CV should include a current photo, statement of philosophy/personal interest, and two references: