Chapter Innovation Award

NOMINATOR(S)

Provide contact information for the primary nominator here. If there are additional/supporting nominators, please list their name and contact information in a "Nominators" documents included with the supporting documents.
Name(required)
Title
Company
Address
City, State, Postal Code
Country
Telephone(required)
Email(valid email required)

NOMINEE INFORMATION

Use this section to provide information about the Innovation Award Nominee.
Is the Nominee a member of the AIIM New England Chapter?
Yes No
Name of Nominee(required)
Nominee Title
Nominee Company
Nominee Street Address
Nominee City/State/Postal Code/Country
Nominee Phone
Nominee E-Mail(valid email required)

Supporting Documents

Please attach supporting document to this form below in PDF or DOC format. This should include the following types of information: nnnnnnnn, nnnnnnn, nnnnnnnn, nnnnnnnn.
Supporting Documentation

Additional Notifications

In the event this application is chosen for an award, please notify the following individuals in addition to the winner and the nominator(s):
Notify additional people if awarded?
Yes No
Provide the name, address, phone and email address for each additional contact.
1. Additional Contact
2. Additional Contact
3. Additional Contact
4. Additional Contact

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