M. Justin Herman Memorial Award

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Nominee Information

Prefix:

Nominee's First Name: *

Middle initial/name:

Nominee's Last Name: *

Suffix:

Title:

Organization**:

Street Address1**:

Street Address2:

City**:

State**:

Postal Code**:

Country**:

NAHRO Region**:

Telephone**:

If country is USA, telephone number should be in the format 555-555-5555

Extension:

If country is USA, extension should be of the format 5555

Fax:

If country is USA, fax should be of the format 555-555-5555

Nominee's Email**:

Achievements and Actions

Address each of the following topics. Add in chronological order with the most current first.

1. Concise Statement of Nominee's demonstrated commitment to solving housing and community problems and evidence of improvement of the quality of life (0- 30 points) ** :

2. Statement showing Nominee's demonstrated excellence through projects, actions or policies in one or more of the following areas: 1. Administration of housing and community development programs. 2. Significant impact on major community problems. 3. Political or governmental service in the field of housing/community development. 4. Economic innovation. 5. Technological contributions. 6. Legal reform. 7. Academic leadership. 8. Influence of public opinion on programs through the news media or other means. (0-50 points) **

2. Statement showing Nominee's demonstrated excellence through projects, actions or policies**:

3. Additional Areas of Excellence in any of the following areas. Add Attachments (including recommendations): 1. Administration of housing and community development programs. 2. Significant impact on major community problems. 3. Political or governmental service in the field of housing/community development. 4. Economic innovation. 5. Technological contributions. 6. Legal reform. 7. Academic leadership. 8. Influence of public opinion on programs through the news media or other means. (0-30 points)**

3. Additional Areas of Excellence **:

4. List of awards and commendations received.**:

5. List of professional affiliations.**:

6. Attach 5 recommendations of other professionals acknowledging the contributions made by nominee below.

Nominator Information