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ASCLS-PA AWARDS |
Award: ______ Key to the
Future Deadline for Awards:
(The nominator must be a member of the ASCLS-PA or District Society Leadership) NOMINEE: _____________________________________________ ADDRESS: _____________________________________________ _____________________________________________________ ASCLS MEMBERSHIP NUMBER of applicant (if applicable): ____________________________
THE ESSAY: (the essay or essays should describe, in measurable terms, the contributions which the nominee has given to the Society; it should present a description of the nominee’s dedication and commitment to the Society and to the Profession through past action, and/or the nominee’s leadership potential that merits the award to which the nominee is nominated. Additional sheets may be attached.)
Name and Office of the Nominator: _________________________________________________ Signature of the Nominator: _______________________________________________________ Signature of the Awards Committee Chair: ____________________________________________ Date Received by the Award's Committee Chair: _______________________________________ |
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