Submission Form: Mary DuVally Award 2019

Please complete the nomination form below.  Please include your name and contact information.  The nomination will be forwarded to the RI APTA BOD for considerration and final approval.  The Award will be given at the Annual Meeting.

(* Denotes Required Fields)

Nominee Information

Name of Nominee Please give a brief description of why you are nominating this person. List areas of service or leadership. Nominee's current employer Name and contact of person submitting

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