NESRT PROFESSIONAL RECOGNITION AWARD - DOC

							       NESRT PROFESSIONAL RECOGNITION AWARD
The wealth of our organization lies in its membership. For this reason the NESRT Board
created The NESRT Professional Recognition Award several years ago as a means to
honor the contribution of one of its members to the profession of radiation therapy.

If you know of a member whose clinical +/or professional attributes provide stellar
qualities to our profession please consider nominating them for the award. To nominate
a member please complete the Nomination Form below and mail to Susan O’Connell,
Past President, no later than February 1st.

The recipient of the award will be honored at the NESRT Spring Conference on March
27th + 28th, receive free admission to the conference and free membership for the year.
In addition the recipient and their employer will receive a plaque to be displayed
recognizing the achievement of the radiation therapist.
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                                Nomination Form
Your name, address and daytime phone number:
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Nominee’s name, address and employer:
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Describe how the nominee has contributed to the profession of Radiation Therapy using
the following criteria: Clinical strength, Educational advancements, Professional
involvement and additional attributes:
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Mail To:
Bert Collyer
Middlesex Hospital OPC
536 Saybrook Rd
Middletown, CT 06457-4712
(860) 358-2100
(860) 358-2110 FAX
Bert65@comcast.net