"*" indicates required fields NomineeName* First Last Title & Agency*Phone*Email* MPLO Member* Yes No Agency Address*Agency Phone*Agency Head*NominatorName* First Last Title & Agency*Phone*Email* MPLO Member* Yes No Award CategoryAward Categories (Pick One) Community Service Mentorship & Sponsorship Leadership Officer of the Year Life Saving Upload Necessary File(s)*Please attach the necessary files describing the reason(s) you have nominated the above-named individual including the specific dates, times, events and other pertinent information that is necessary to aid the Award Committee in the selection process. Drop files here or Select files Accepted file types: pdf, doc, jpg, png, Max. file size: 50 MB, Max. files: 6. Consent* I have filled out this form accuratelyIncomplete nomination forms will not be accepted. If multiple nominees, one form for each must be submitted Δ