KHIMA MVP NominationKHIMA MVP Nomination Nominee InformationName * Name Name Name Email * Phone * Address * Address Address Address Address Address State Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming 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 State Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Address Project Information Project Name * Nominee Role * Outcome of the project Upload any supporting documentation Drop a file here or click to upload Choose File Maximum upload 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
