Ohio Society of Radiologic Technologists

Life and Honorary Membership Nomination Application

Review the nomination eligibility criteria for the Life or Honorary Membership Award posted under the Recognitions Tab. The deadline to nominate is January 15. Indicate below the type of membership for this nomination.

Nomination Membership
Nomination Membership
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Please type full name.

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Enter street address

Enter city

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Nominee Credentials(*)
Nominee Credentials
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Please enter a valid email of the form userid@email.com

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In the text box below, please provide a pertinent biographic sketch of the nominee and a justification for the award of Life or Honorary Membership. The biographical sketch is limited to no more than 300 words.
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Type the numbers below, click the submit button, and check your email for your copy of the submitted form.

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