DVMA Member Awards Nomination Form

YOUR Full Name *

YOUR Email Address *

NOMINEE'S Full Name *

NOMINEE'S Email Address

Member Award Category:

Veterinarian of the Year Award

Veterinary Technician of the Year Award

Lifetime Achievement Award

Reason for Nomination (summarize in 1-2 sentences) *

What sets this member apart from others?

What has this member contributed to his/her community?

How has this member worked to support the mission of DVMA?

DVMA Mission Statement: Community of veterinary practitioners and support staff that work together to foster well-being for its members, promote public awareness of the value of veterinary medicine, champion excellent veterinary practices in the state, as well as strive to work together to promote animal welfare.

Letter of Recommendation from DVMA Member #1 (required for all member award nominations) *

Letter of Recommendation from DVMA Member #2 (required for Lifetime Achievement Award)

Nominee Photo 1 *

Nominee Photo 2

Nominee Photo 3