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URISA Awards Nomination Form

First, please give us some information about you:

Your First Name
Last Name
Credentials Held (GISP, PhD)
Job Title
Organization
Address
Address2
City
State/Province
Zip
Country
Phone
Email

Please give us some information about the person you are nominating:

First Name
Last Name
Credentials Held (GISP, PhD)
Job Title
Organization
Address
Address2
City
State/Province
Zip
Country
Phone
Email
Your relationship to Nominee:
Award nominating this person for (choose one)
Reasons for nomination.
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