HLAA Alumnus/Alumna of the Year Nomination

Future Students

Undergraduate Students

Graduate Students

Parents & Family

Alumni

Faculty & Staff

Researchers

Patients

Colleges & Schools

The deadline to nominate someone is July 12, 2024.

Please note: These forms do not save and may reset. We recommend you answer the questions in a Word Doc, or other method that saves, and then copy/paste your answers into our form.

If you do not receive an email confirmation upon completion of the form, please contact Randa Hall at This email address is being protected from spambots. You need JavaScript enabled to view it..

Nominator Information

Name:(*)

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Program(s) from which you graduated:(*)

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Email:(*)

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Phone Number:(*)

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Nominee Information

Name:(*)

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Program(s) from which the nominee graduated:(*)

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Employer:(*)

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Title:(*)

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Email:(*)

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Phone Number:

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Describe the nominee's outstanding leadership in the following areas.

A. Leadership in one's work(*)

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B. Contribution to the field and participation in local/state/national healthcare organizations/associations(*)

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C. Involvement in community service(*)

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D. Active engagement in supporting UAB students and alumni individually, through their program, HLAA and/or Department, School, UAB(*)

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Additional information

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CV/Resume of Nominee - REQUIRED

Upload resume/CV (*)

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Supporting Materials - OPTIONAL

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reCAPTCHA(*)

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Colleges & Schools

Department of Health Services Administration

Nominator Information

Nominee Information