KHIMA MVP NominationKHIMA MVP Nomination Nominee InformationName * Name Name Name Email * Phone * Address * Address Address Address Address Address StateAlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Address Years in HIM * Job Title (most recent or highest earned) * Highest degree earned Additional licenses or certifications Nominator InformationName * Name Name Name AHIMA ID Number * Email * Phone * Address * Address Address Address Address Address StateAlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Address Project Information Project Name * Nominee Role * Outcome of the project Upload any supporting documentation Drop a file here or click to upload Choose FileMaximum file size: 268.44MBReason for Nomination Why have you chosen to nominate this member for the MVP award? Please provide a well written statement that is at least one paragraph and responds to the following questions:What type of project did the member complete?How did the member play a large role in the project?Why is the project significant to the HIM profession? * Nominator's Signature * Clear Signature of * Date * If you are human, leave this field blank. SubmitΔ
