Veterans Caucus Award Nomination

Veterans Caucus, Inc.

A Caucus of the American Academy of Physician Assistants
P.O Box 362, Dover, DE 19903

Thank you for taking part in the Veterans Caucus annual award program. Recognition of veterans either as a civilian or in military life is an important part of the Veterans Caucus. Please be aware that there is no membership requirement in the Veterans Caucus for nominees.

Please use a separate nomination form for each person or award. You may nominate as many people as you like, or you may self-nominate.

Veterans Caucus of the AAPA annual awards:

• Outstanding Uniformed Physician Assistant of the Year
• Outstanding Civilian Physician Assistant of the Year
• Veterans Caucus Physician Assistant of the Year

These are awarded at the Memorial Day Ceremony each May during the AAPA National Convention.

Nominations due February 15

The following information is for the individual completing this form for nomination of another individual.

Submitters Name(*)
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Day Phone (xxx-xxx-xxxx)(*)
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Submitters Email(*)
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The following information is about the individual you are nominating for the Caucus award. Please be as complete and concise as possible with all of the required information.

Award Category
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Nominees Name(*)
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Military Branch
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Military Status
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Award Justification
(Limited to 1000 charcters) include a background of the nominee, describe what the nominee has done to earn the award, describe any challenges that the nominee had to overcome and describe the impact that the nominee has made.(*)
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