KHIMA Recognition Nomination FormKHIMA Recognition Nomination Form Nominee InformationNominee * Nominee Nominee Nominee Credentials Nominee's Address * Nominee's Address Nominee's Address Nominee's Address Nominee's Address Nominee's Address StateAlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Nominee's Address Nominee's Email * Employer Job Title Does your nominee know about this nomination? * Yes NoSelect the recognition you would like to make the nomination for. * Years of Service In Memorium Substantial MilestonesIn 250 words or less, provide a short recognition for any KHIMA member who has significantly contributed to the profession and is either approaching retirement, has retired within the past 15 months, or has reached a notable milestone in years of service (20, 25, 30, 35, 40, 45, 50, 55, or 60 years), and has not been previously recognized. The person submitting the recognition should indicate whether he/she/they wish to speak on behalf of the honoree. If speaking on behalf of the honoree, please provide the speaker's name and contact information below. Plan to keep the address under 3 minutes. * 0 of 250 max words In MemoriumIn 250 words or less, explain the member's contributions to the profession, AHIMA, and/or KHIMA Board/Committees. The person submitting the recognition should indicate whether he/she/they wish to speak on behalf of the honoree. If speaking on behalf of the honoree, please provide the speaker's name and contact information below. Plan to keep the address under 4 minutes. * 0 of 250 max wordsSupporting DocumentationIf available, please provide: A picture of the honoree. Proof of the milestone selected, or A copy of the obituary or A link to an obituary page so that additional information may be available to the presenter, if needed. A picture of the honoree. * Drop a file here or click to upload Choose FileMaximum file size: 268.44MB Proof of the milestone selected. * Drop a file here or click to upload Choose FileMaximum file size: 268.44MB A copy of the obituary. * Drop a file here or click to upload Choose FileMaximum file size: 268.44MB Link to the obituary page * Nominator’s Contact InformationNominator * Nominator Nominator Nominator Company Nominator's Email * Nominator's Phone Will you be speaking on behalf of the honoree? * Yes No* Please plan to keep the address under 3 minutes for years of service, and under 4 minutes for in memorium. Submit If you are human, leave this field blank. MembersAHIMA Hi-Five CommunityAnnual Business Meeting Reports2019 KHIMA Annual Business Meeting2020 KHIMA Annual Business Meeting2021 KHIMA Annual Business Meeting2022 KHIMA Annual Business MeetingAwardsCall for Board NominationsJoin KHIMAVolunteer
