Go to USC home pageGo to Arnold School home page

SCHEART Quarterly Award
Nomination Form

* indicates required fields


Ham Nominee (please enter information about nominee)

* Nominee's Name:
Call Sign:
License Class:
Address:
Phone Number:
E-mail:
Nomination Quarter:
Support Agency:
Support Agency Contact Name:
Support Agency Contact
Phone Number:
Position/Job Title:
Number of years as a Ham:

Please provide specific bullets on how the Ham you are nominating made significant contributions to your agency, region, or program:

Additional Information:

Give one specific example of what makes this person stand out and why they're deserving of recognition.

 


Nominated by (please enter your information):

Your name:
Relationship to Nominee:
Address:
Phone Number:
* Email:
 

 



Columbia, SC 29208 • 803-978-7576 • gipsond@mailbox.sc.edu