EmailMe Form - 2019 ANA Awards Nomination Form

For which award are you nominating? *

Click on the above menu to make your selection.

Tell us about the nominee

Nominee's Name *

First Last

Nominee's ANA numbers

(if known)

Nominee's street address

Nominee's city

Nominee's state

Nominee's zip code

Nominee's phone number

### - ### - ####

Nominee's date of birth

MM / DD / YYYY

Tell us why your nominee is deserving. TO BE VALID, EACH AWARD MUST INCLUDE A BIOGRAPHY OF THE NOMINEE. To provide a biography, answer the questions below OR attach a file immediately below. Biographies must be between 50 and 100 words.

Attach a document that explains why your nominee is deserving.

Multiple uploads are allowed.

The above nominee deserves this honor because of his/her contributions to and achievements in the field of numismatics, which are as follows:

Use this space below to list any international, national, regional or local numismatic organizations of which the nominee is/was a member of. List any offices held and the year(s).
(Example: Vice-President 2014-2016; etc.)

Please list all numismatic accomplishments

Please list published numismatic works, including Title, Publisher and Date published

Please list numismatic awards, including the year the honor was received.

Military Service Branch, if applicable

Educational Background

High school

College or university

Graduate or professional school

Please list the names of any college, university, graduate school or professional school, the degree or title earned, and the years attended.

Please list numismatic collecting specialties:

Tell us about you

In case we have any questions about the nominee, how do we get in touch with you?

Your name *

First Last

Email *

Your Phone *

### - ### - ####