Arizona Wildfire & Incident Management Academy

2016 Wildland Firefighter of the Year

Nomination Form

Sponsored by:
Arizona Wildfire and Incident Management Academy

We are accepting nominations for this soon to be annual award that will be given to a wildland firefighter that shows a commitment to community service, going above and beyond the call of duty and contributions to the fire service.

Do you know that exemplary firefighter that deserves this award? Please complete the following nomination form along with a narrative explaining why you think this individual is deserving of this honor.

2015 Firefighter of the Year: The Blue Ridge Hotshots
The Blue Ridge Hotshots
Superintendent Brian Frisby

Rules:

  • Individual can be nominated for acts of courage or for making contributions to improve quality of fire service during 2016
  • Nominee must represent the character and commitment of wildland firefighters in the southwest (must work for an agency in the southwest) This includes, but is not limited to: leadership, duty, respect, integrity and community service.
  • Nominations must be received by February 1, 2017
  • Winner will be announced during the academy dinner on Tuesday, March 14, 2017
  • Complete form below along with a narrative
  • Mail Form To: AWIMA 1700 Iron Springs Rd. Prescott, AZ 86305

Nominator Information:

First Name: ______________________________
Last Name: ______________________________
Title: ______________________________
Agency: ______________________________
Street Address: ______________________________
City: __________________________ Zip ________
Work phone: ______________________________
Cell phone: ______________________________
E-mail: ______________________________

Nominee Information:

First Name: ______________________________
Last Name: ______________________________
Title: ______________________________
Agency: ______________________________
Street Address: ______________________________
City: __________________________ Zip ________
Work phone: ______________________________
Cell phone: ______________________________
E-mail: ______________________________

Nomination Information (narrative):

Please use the space below to tell us the reason why this individual deserves to be this year's recipient:
(if you need more space attach a separate page with your entry)








Mail Form To: AWIMA 1700 Iron Springs Rd. Prescott, AZ 86305

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