Call for Nominations - DGS Distinguished Service Award
Candidate Name and Location (must be a current member of DGS)
Candidate Name (first, middle initial, last): Address: City: State: Zip or PostalCode: Country: Telephone: Fax: Email Address:
Record of Service: List up to five principal positions of service to DGS or the DGcommunity, and briefly describe primary responsibilities for each position.
Proposed Citation: (to appear on the award certificate -- citation should begin"For contributions to the field of digital government through sustained service..." followed by a phrase of not more than 20 carefully edited words that reflectthis candidate's demonstrated service to the community)
References: At least two letters of reference from the DGS member network are required, including one from the nominator. The nominator has obtained an indication of willingness to serve from each individual listed as a reference below.
Reference Name: Address: City: State: Zip or Postal Code: Country:
Reference contact info: Email
Nominator: name, title, DGS membership status, email
Please submit your completed form by March 31 to dgs Awards Committee Chair(Rodrigo Sandoval, 2016-2017) @ firstname.lastname@example.org