MAATA Honors and Awards Application Form – MAATA – Mid-America Athletic Trainers' Association

Sponsor Information

Information to be completed by the individual completing the nomination form.

Name of Sponsor *

Sponsor Current Position *

Sponsor Current Place of Employment *

Sponsor Address

City

State

Zip

Sponsor Work Phone # *

Sponsor Home/Mobile Phone # *

Sponsor E-mail *

Nominee Information

Name *

Current Position *

Employer *

City *

State *

Zip *

Work Phone # *

Home/Mobile Phone # *

E-mail *

How long have you known the nominee and in what capacity? *

Is the nominee aware of your award application on their behalf and have you verified that they meet the minimum award criteria (years of membership etc.)?

Yes

Award Nomination *

What makes this candidate deserving of this award? Please view the award description and address those criteria in your answer. Please note, the nomination will require additional letters of support. *

Once nominations have closed, the Honors and Awards committee will notify qualified nominees and coordinate collection of additional letters of support and resume/vita.

If you are human, leave this field blank.