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OkHIMA Outstanding Member Award Nomination Form

Part I: The Nominee

Note: It is suggested that the group or individual nominating this candidate inform the nominee that they are proposing his/her name to guarantee that the information submitted is accurate.
1. About the Nominee
This question requires a valid email address.
Present Employment Status
Individual Notified of Nomination? *This question is required.
3. Nomination submitted by
Nominator's Signature *This question is required.
Signature of