NorthEast Emergency Medical Services, Inc.
NorthEast EMS MA Region III 2018 Award Nomination
Outstanding Contribution to EMS in Region III
All nominations must be received by August 27, 2018
NorthEast EMS Inc. is honored to request nominations for the 2018 Annual Outstanding Contribution to EMS in Region III awards. We are grateful for this opportunity to recognize and celebrate the outstanding contributions Region III EMS professionals make to safeguard the health, safety and wellbeing of course communities. Awards will be presented on September 20, 2018 at 6:00 pm at the Haverhill Country Club.
Awards will be categorized as follows:
• EMS First Responder
• BLS Provider
• ALS Provider (Advanced and Paramedic)
• EMS Physician
• EMS Nurse
• EMS Educator
• Group Save
Some examples of Outstanding Contributions to EMS include, but are not limited to:
• Actions that resulted in saving a life
• Actions “above and beyond the call of duty”
• Improving the level of EMS service provided to a community
• Improving the quality of the EMS system
• Improving EMS training and education
• Improving working conditions of fellow EMS providers
To nominate an individual or group of individuals please fill out and submit the following information no later than August 27, 2018
If you have any questions, please contact firstname.lastname@example.org or call 978-792-5477.
Your Organization / Affiliation
Your Email Address
Your Primary Phone Number
If nominating a group list the names and email addresses of each participant.
Nominee's Organization / Affiliation
Nominee's Email Address
Nominee's Primary Phone Number
Select a Category
EMS First Responder
ALS Provider (Advanced / Paramedic)
Narrative - Please describe why you believe the nominee(s) should be recognized for Outstanding Contribution to EMS in Region III. Please provide as much detail as possible to assist the Selection Committee in making their decisions.
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