NJSBA MOH SUBMISSION FORM

NEW JERSEY STATE BAR FOUNDATION - MEDAL OF HONOR

NOMINATION FORM

Please Make Your Submission No Later Than Friday, March 5, 2021.

Step 1 (About The Nominee):
Please Enter The Following Information For The Person You Are Nominating:

Full Name of Nominee:
Street Address:
City:
State:
Zip code:
Phone:
Email:

Step 2 (You/Your Organization):
Please Enter The Following Information About You And/Or Your Organization:

Your Name:

Your Phone Number:

Your Email:

Nominating Organization Name (If Nomination Is On Behalf Of Organization):

Address Information:
Street Address:
City:
State:
Zip code:

Step 3 (About The Nominee):
Please Upload The Following Information About The Nominee (Microsoft Word or PDF Documents Are Preferred).

Biographical Sketch:

Summary of the Nominee's Accomplishments

Any additional information about the Nominee that should be considered by the Committee in its evaluation and selection process

Step 4:
Please Enter Your Initials Below To Digitally Sign This Document.
By submitting this form and entering my initials below, I certify that the information I have provided is true.

Your Digital Signature (Please enter your initials here)

Questions?
Contact Mary Jean Barnes at [email protected] .