| Nomination for Gordon Burt Affleck Award Form
Nominee Name
Date
Nominated By
1. Company Affiliation
A. Name of Employer
B. Address of Employer
C. Telephone Number
D. Job Title
E. Number of Years in Purchasing
F. Scope of Responsibilities
2. Association Activities (Include local, district, national)
A. Date Joined NAPM-Utah
B. List offices held/When
C. List Committee Service/When
D. Teaching and/or Arranging Seminars/Workshops to Improve Professionalism
E. Date received C.P.M. Certification
3. Related Purchasing Activities (Non-NAPM)
A. Publication of Articles and/or Books on Professionalism
B. Offices Held
C. Classes Taught/Organized
D. Company Activities (Contributions to Company, Restructuring Department/Functions/Teaching/Organizing Education
Programs)
4. Business, Civic and Fraternal Activities (Give Brief Resume of Offices Held and Services Rendered)
5. Honors Received (Professional, Business, Civic and Others)
6. Intangibles (Personal Qualifications, Leadership Strengths, Recognition to
Profession, Unselfish Efforts to Profession)
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