Intent to Nominate

Please select the award you are nominating an individual for, and submit this completed form. Full descriptions of each award are available at www.imla.org (under Membership, Awards). NOTE: This is the Intent to Nominate form, a full nomination form, specific for each award, is available on IMLA’s website. Also, this form is not needed for the Jim H. Epps III Award for Longevity of Service to a Community. If you have questions, please e-mail Veronica Kleffner at vkleffner@imla.org or phone 202-466-5424 x7111.

Please Select ONE award(*)
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Name of nominee(*)
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Nominee's Job title(*)
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Name of nominator(*)
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Nominator title(*)
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Address of nominator(*)
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Telephone number of nominator(*)
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E-mail address of nominator(*)
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