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 * 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.