AFCEA International - The Armed Forces Communications and Electronics Association

INSTRUCTIONS:

Nomination form must be endorsed by an AFCEA Regional Vice President (RVP). Supporting information is limited to one page; attachments will not be considered. Duplicate forms are acceptable.

DEADLINE FOR RECEIPT OF NOMINATIONS – NOVEMBER 14, 2005.

If you have any questions, contact Maureen Cirrito at AFCEA (703/631-6174).

Click here to download the PDF form.

NOMINEE INFORMATION
First Name:
Last Name:
DOB:
Rank:
Title:
Organization:
Address:
City:
State:
ZIP:
Phone:
FAX:
E-mail:
Member Number:
Years:
Chapter:
NOMINATOR INFORMATION
First Name:
Last Name:
Member Number:
Rank:
Title:
Organization:
Address:
City:
State:
ZIP:
Phone:
FAX:
E-mail:
ENDORSEMENTS
RVP Endorsement:
SUPPORTING JUSTIFICATION (Note: All supporting information must be contained to one page. Additional pages will not be considered.)
Year DYA Award was Presented:
Chapter Affiliation at Time Award Given:
Write Up: Write-up should include the following information: Young AFCEAN involvement which exceeds the norm Total AFCEA involvement with emphasis on current activities Ways the candidate involves his/her peers in AFCEA activities Specific contributions in support of AFCEA’s mission, goals and objectives Ongoing Young AFCEAN contributions since winning DYA Award