Bruce Witz Memorial Award Nomination form

1Your Information
2Nominee Information
This award honors a small company from each region that consistently offers a quality product and outstanding service to the members of that region. In addition, this small company should, through their contribution of time and effort, provide the most significant contribution to the goals of the NYSSRC in a single calendar year.

Please complete each field below with as much information you know about the individual you are nominating. It is not necessary to complete each field with your nominee information, but the more detailed, the better informed decision the Awards committee and Board of Directors can make.

Any categories below indicated with an asterisk (*) are required fields.

Your Name
Your Email
Scroll to Top