EMS Accolades Report

The intention of this report is to make a quick, simple way for a peer or service head to nominate a candidate for the EMS Annual Awards. Often great accomplishments go unacknowledged. By filling out this initial form you are doing your part to recognize those who deserve it. Once this report is submitted, a member of the EMS bureau will contact the person who submitted the form for more information.
Name
First Last
Title of Person Submitting form
Unit or Department Name
Contact Information
Email
Cell phone or best number to reach
Event or Occurence Details
Event or occurence that you would like to make sure is acknowledged
Event or occurence Date
MM slash DD slash YYYY
Quick description of event or occurence
Attatch any associated articles here
Max. file size: 256 MB.
Attatch photo of event or occurence here
Max. file size: 256 MB.
Attatch photo of person here
Max. file size: 256 MB.

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fstems@dos.nh.gov

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