Salute to Healthcare 2017

Awarded by the Lufkin/Angelina County Chamber of Commerce


WHO CAN BE NOMINATED?

Any individual, institution, professional, student, volunteer or program, who through their individual or collective actions have made an extraordinary impact in the Lufkin/Angelina County healthcare community.

Their acts of service will represent a display of dedication to excellence in their area of expertise beyond the scope of their jobs. Through their commitment to their profession and community, they serve as an inspiration to others in an effort to improve the quality of healthcare and discover new ways to assist those in need.


I AM NOMINATING (CHECK ONE)

 Healthcare Professional: Physician, Dentist, Healthcare Administrator, Department Head, Allied Health Professional
 Nurse
 Individual of Merit: Board Member, Philanthropist, Journalist, Government Official, Company, or Foundation Executive, Community Leader, Volunteer
 Lifetime Achievement Award: The Lifetime Achievement Award is designed to honor an individual, who, over his/her lifetime, has made a significant impact or changed history in the healthcare industry in Angelina County.

The recipient will be selected by an anonymous committee from all nominees submitted for this award and will be announced at the event.

All nominations must be received by 5:00 p.m. September 29, 2017 to be eligible for the awards. Recipients will be honored at the Salute to Healthcare Banquet on Thursday, November 9, 2017.


NOMINATION INFORMATION

Nominee Name
Title
Organization
Phone
Address
City
State
Zip

PLEASE SUBMIT THE FOLLOWING:
1. Attach a brief description of the nominee’s achievements and contributions. Explain how these achievements go above and beyond the scope of the nominee’s job. Your explanation of why your nominee should be chosen will be a primary consideration of the judge’s decision.

2. With reference to your nominee, attach to this application a list of activities, programs, in-kind contributions, etc. that directly benefited the Angelina County community. Please provide as much back-up information (up to 10 pages) to illustrate the involvement and any measurable results attributable to the contribution of the nominee.


NOMINATOR'S INFORMATION

Your Name
Title
Organization
Email
Address
City
State

The information contained in this application will remain confidential and will be used solely for purposes of the award selection. Materials submitted will become the property of the Lufkin/Angelina County Chamber of Commerce.

I certify that the information submitted is true and correct to the best of my knowledge.

Nominator's Signature

DEADLINE FOR SUBMITTING ENTRIES: SEPTEMBER 29, 2017
Submit the online form or return entries to:
Lufkin/Angelina County Chamber of Commerce
Salute to Healthcare Nominee
1615 South Chestnut • Lufkin, TX 75901
Tel: 936-634-6644 • Fax: 936-634-8726
TCharanza@LufkinTexas.org