Nominator Name *

What is your name?

Nominator Email *

What is your email?

Nominee Name *

Please list the name of the person you are nominating

Nominee Agency *

What agency does the nominee currently work for?

Is the nominee a member of IPRA? *

Is the nominee currently on the IPRA board of directors? *

Enter required value Yes No

What certifications does the nominee currently hold? *

Has the nominee worked at least 8 years as a full-time professional? *

Why are you nominating this person? *