KHIMA Award Nominations

Award Nominations

PLEASE COMPLETE A SEPARATE FORM FOR EACH NOMINATION.

KHIMA is offering seven recognition awards to recognize KHIMA professionals in the following four areas:
1. Honoring leadership in the field
A. Outstanding Member Award
B. Champion Award
C. Volunteer Award

2. Rewarding Contributions that Build the Knowledge Base
A. Achievement Award

3. Recognizing Excellence in Preparing Future HIM Professionals
A. New Frontier Award
B. Rising Star Award
4. Encouraging Fresh Talent and New Leadership A. Motivator Award

NOTE: Please email the following supporting documentation to Reba Bayuk, rbayuk@gpha.com.
1) Nominee’s resume or curriculum vitae, if available.
2) Letters of support from others who are familiar with the nominee’s accomplishments.
3) Other written materials such as articles, project descriptions, etc., where applicable.

Question Title

* 1. Select the award you would like to make a nomination for.

Outstanding Member Award

Champion Award

Volunteer Award

Achievement Award

New Frontier Award

Rising Star Award

Motivator Award

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* 2. Nominee Information

Name:

Address:

Address 2:

City/Town:

State:

ZIP:

Country:

Email Address:

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* 3. Nominee Credentials

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* 4. Nominee Employer and Title

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* 5. Does your nominee know about this nomination?

Yes

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* 6. In 250 words or less, explain the nominee’s qualifications for the award and why you think your nominee deserves state recognition.

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* 7. Please list additional individuals (HIM or non-HIM professionals) that you feel would be able to provide additional information to support this nomination. Please include name, phone number and email address.

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* 8. Contact information for person making the nomination

Name:

Company:

Address:

Address 2:

City/Town:

State:

ZIP:

Country:

Email Address:

Phone Number: