Hank Nuwer Hero Award Application - Hazing Prevention Network

Please tell us a bit about yourself (the person who is making the nomination):

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Your First Name *

Your Email *

Your Position/Title

Does the person you are nominating know they are being nominated? *

Please note: We will notify each nominee and let them know they have been nominated. HOWEVER, we do not disclose who nominated them. Your information remains private.

Your Last Name *

Your Phone *

Your Institution/Organization/School/Company *

Now, tell us about the person you are nominating for the Hank Nuwer Hero Award:

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Nominee First Name *

Nominee Email *

Nominee Position/Title

Nominee Last Name *

Nominee Phone *

Nominee Institution/Organization/Company *

Nominee Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Now, tell us why you are nominating this person for the Hank Nuwer Hero Award:

What are some characteristics you have witnessed from this person? *

In what context do you know them or know of them? *

How have they been instrumental in preventing, detecting, reporting or otherwise deterring hazing? *

In your own words, briefly state why you feel they are deserving of the award: *