NCOTA Nomination Form for Annual Awards & Recognition

Please use the form below to submit your nomination for an NCOTA award. All nominations MUST be received through this form. Let’s recognize the positive impact each nominee has on our profession and NCOTA.

Important Guidelines & Requirements

  • Letters of Recommendation: Formal letters are encouraged, but they are only required for the Suzanne C. Scullin Award and the Janice O’Conner Alvarez Award. Letters help strengthen a nomination.
  • Resume and CVs: The Suzanne C. Scullin Award and the Janice O’Conner Alvarez Clinical Fieldwork Education Award nominations are required to include the nominee’s curriculum vitae (CV)
  • Extra Materials: If you are unable to upload documents relevant to the nomination on this form, the supporting materials can be emailed to office@ncota.org, but they must be
    received prior to the official deadline.

Deadline: June 30, 2026

Section 1: Nominator Information

Section 2: Nominee Information

As it should appear on the award certificate
As they should appear on the award certificate
Nominee NCOTA Membership Status

Section 3: Award Selection & Specialty

This item is only required for the Outstanding Practice Award

Section 4: Nomination Narrative & Materials

Supporting Documents

Please upload all documents as PDFs.

Encouraged for all; Mandatory for Scullin & Alvarez
Encouraged for all; Mandatory for Scullin & Alvarez
A CV is MANDATORY for Scullin & Alvarez Awards
This photo may be used on social media, our website, and at the awards ceremony.