AMP Service Distinction Award Nomination Form

Please enter your information below and click the "Submit Form" button to complete your nomination form.
All fields are required.

If you have questions, please contact Amanda Smithey at asmithey@amppartners.org or 937.797.1595.

Nominee name

Nominee utility or organization

Describe the nominee’s public power career; please note years of service, municipal electric utilities served and/or pertinent employment information.

Describe how the individual has made significant contributions to public power and supported the mission, vision and values of AMP.

Describe how the individual has dedicated their career to the betterment of public power communities.

Provide any additional supporting materials, including photos, by uploading file(s) below.

File upload

Delete all uploads

Choose files or drag here

Acceptable file formats: jpg, jpeg, png, gif, tif, tiff, bmp, pdf, doc, docx, ppt, pptx, xls, xlsx, zip

Your name

Your title

Address

Phone

Email address (must include @ symbol)

Verification