The Lifetime Achievement Award is designed to recognize outstanding individuals who have made a life-long contribution to the high quality of emergency medical services within the greater Miami Valley. The first recipient was Tom Long, who served as the EMS Coordinator for more than 30 years at Miami Valley Hospital in Dayton, Ohio.

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* 1. Submitter Name

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* 2. Submitter Phone Number

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* 3. Submitter Department

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* 4. Submitter Email

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* 5. Name (Individual/Organization) of Nominee

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* 6. Department of Nominee

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* 7. Nomination Narrative

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