Outstanding Service Award

Outstanding Service Award

NOMINATION FORM

** Nomination deadline: August 30, 2007

Criteria

OR-IASIU’s Outstanding Service Award recognizes contributions to the insurance industry, an individual’s company, the community and the association. Nominees may be anyone who has made a substantial contribution to the insurance anti-fraud efforts.

Entry Form

Nominee’s Name:
Company/Agency Name:
Position within Company:
Nominee’s immediate supervisor:
Supervisor’s telephone:
Supervisor’s e-mail:
Nominator’s Name:
Nominator’s e-mail:

Describe Nominee’s substantial service contribution to the Insurance Industry anti-fraud efforts: