Mitchell Stallings Memorial Award
Nomination Form - Deadline, May 5, 2017

The Mitchell Stallings Memorial Award, given in memory of Past Chairman Mitchell Stallings, recognizes a lifetime of leadership, integrity, and service to the industry. Please complete this form and provide along with the it the following:

  • a written statement describing the nominee's accomplishments and the reason(s) he or she should receive the award;
  • your nominee's resume and/or biographical information; and
  • other documents such as news articles, press releases, etc., that describe your nominees's activities
Please fill in the information requested below. Fields with an * are required.
*Nominator Name:  
*Nominator Agency:  
*Nominee Name:  
*Nominee Title:  
*Nominee Agency/Organization:  
*Describe nominee's accomplishments and reason(s) he or shee should receive the award  
Upload Resume/Biographical Information
I have reviewed, understand, and accept the nomination and selection guidelines, and understand the Selection Committee's decision is final and not subject to dispute or question.

Electronically Signed and Submitted by: