EMPoweRx Conference Award Nomination Form

EMPoweRx Awards Submission Form

Nominator

Details of the person submiting the nomination.

Nominee Information

Details about the person being nominated.
Please provide a brief statement (maximum 500 words) explaining why the nominee should receive the award, highlighting their contributions, achievements, and impact. Be specific about their accomplishments and their significance to the award category.
Click or drag files to this area to upload. You can upload up to 2 files.
Attach any relevant supporting documents, such as a CV, letters of recommendation, project summaries, or data that demonstrate the nominee's qualifications and achievements.