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Richard Neubauer Advocate Award Nomination Form
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Please submit this form by March 25th in order for it to be considered for the upcoming Leadership Day.
For questions, please contact Shuan Tomlinson at 202-261-4547 or email
stomlinson@acponline.org
.
Submitted by:
Nominee Name
ACP Chapter
Please provide, in as much detail as possible, the following information about the nominee:
What contributions has this individual made to ACP’s federal advocacy activities? Please be as specific as you can.
Has this individual been involved in any state-level advocacy? If so, what?
Why do you think this individual is deserving of this award?
Other Comments:
