Award Nomination Form
1. NOMINEE’S INFORMATION
Agent's Name:
*
License Number:
Phone Number:
*
Email Address:
*
Address:
2. NOMINATION:
Which award they are being nominated for?
Recovery Agent of the Year
Bail Agent of the Year
Lifetime Achievement Award
Why do you believe your nominee should win the award?
3. NOMINATOR'S INFORMATION:
Nominator's Name:
Nominator's License Number:
Nominator Address:
Nominator's Phone Number:
Nominator's Email Address:
Submit
