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Award Nomination Form

Awards can be given at either NEMSA Conference.
The deadline for these awards is January 1st or March 1st, of the current year, or bring to the NEMSA Conference before 1pm on Saturday.

Nominations must be supplemented with pertinent information supporting your nomination. To nominate someone for an award, either fill out the form below or download the PDF version. Nomination forms not fully completed will not be considered.


Nominee's Information












Nominator Information














Award Nomination

Check the boxes below for all awards you are nominating the recipient for.

This award is presented for outstanding Achievements that an individual has attained or accomplished in the emergency medical field.

This award is presented for outstanding actions of a person rendering aid to an individual in medical crisis that warrants the person being called a hero. This can also be presented to an EMS provider that goes above and beyond the call of duty.

Awarded to the EMR who has demonstrated outstanding skills, training and services to their community and/or State of Nebraska.

Awarded to the EMT who has demonstrated outstanding skills, training and services to their community and/or State of Nebraska.

Awarded to the Advanced Provider who has demonstrated outstanding skills, training and service to their community and/or State of Nebraska.

This award is given to the EMS Instructor who has made the greatest contribution to local or state EMS as an instructor. The person must be a State of Nebraska licensed EMS Instructor providing education for EMR, EMT or Advanced Provider personnel.

 

The Hall of Fame Award will be chosen by a unanimous vote by the the NEMSA Board of Directors.

Nominations may be submitted at any time during the calendar year. This in not an annual award and may be given to several recipients or not at all during the calendar year. An awardee does not have to be an actual provider or NEMSA Member. They can be a spouse, political figure, etc. One who has been a steadfast supporter of individual providers, services or the profession as a whole. An awardee can be a provider of any level from an EMR to paramedic, nurse or physician. There is no year of service requirement. The individual must have made a significant impact on their individual service, statewide EMS or variety of services in their area or region. Some examples of this are direct patient care, quality assurance/improvement, training, professionalism, CISM, community awareness/education, legislation, political action, medical direction. An awardee can be an individual who has made significant contributions to the education of EMS providers through time, dedication and the amount of involvement with classes, Hall of Fame award may be presented posthumously. Award will be presented at Nebraska EMS Conferences. The Hall of Fame Award will be chosen by a unanimous vote by the the NEMSA Board of Directors.


Pertinent Information to Support Nomination

Please upload a document containing pertinent information to support your nomination.


Creighton University
EMS Billing Services
University of Nebraska Medical Center
2017 NEMSA Conference
Nebraska Soybean Association
Nebraska Emergency
Medical Services Association

P. O. Box 1858  \\  Fremont, NE 68026-1858
Contact us at info@nemsa.org

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