Nominations for 2016 have closed.

Instructions: Complete all information below. Be as specific and detailed as possible. Provide as many attachments as required to assist the validation of the incident, eligibility of the nominee/team, and level of Award nomination. Statements/Affidavits should contain as much detail as the party can recall including all facts and occurrences to clearly show what manner and to what extent an extraordinary effort was made, witness names, persons rendering assistance during the incident and all pertinent circumstances and data showing the precise nature and level of competence involved. Additional information/attachments should be emailed to nominations@higginsandlangley.org.

Before filling out this form please carefully read the awards criteria. If you’d prefer to print out the form and send it in, you may download it in PDF format.

2016 nominations have closed.