2019 Northern Virginia EMS Council Award Nomination For

Emergency Preparedness Award



This is an offical nomination form for a regional EMS award. Please consider all the following information before you complete the form.

o        Has the nominee met all of the criteria for this award category? If not, please consider another category. Nominees that are incorrectly categorized will not be considered.

o        Do you have supporting materials if the category requires them? Supporting materials should be emailed to northern@vaems.org after you submit this form

o        You will need a high resolution digital photo of the nominee. Photo must be emailed to northern@vaems.org after you complete this form 

o        Will you meet the required deadline for entries?

o        Supporting materials and Photos can be sent after this form is completed.


Please fill out the following information below.

CRITERIA: Any individual, EMS organization or EMS response group within the Commonwealth of Virginia that has demonstrated comprehensive and/or significant accomplishments for programs that provide preparedness, response and recovery from natural, man-made and preplanned events, which cause a significant impact on the agency and the community. These activities should directly relate to and impact the provision of emergency medical care during these events.

ELIGIBILITY: Any individual, EMS organization or EMS response group within the Commonwealth of Virginia


Examples of programs meeting eligibility for this award would include; Disaster Response Teams, Community Emergency Response Teams, Continuity of Operations Planning, Mass Casualty Incident Training programs, pandemic planning and surge event planning. Eligible applicants include persons or entities developing or managing such programs. 

Nominee's Information


Your Information

Powered by ChronoForms - ChronoEngine.com

Back To Top Website Security Test