You must have JavaScript enabled to use this form. 1 Start 2 Complete Nominator Name * Nominator AMA Number * Club Affiliation AMA District * Nominee Name * Relationship to Nominee * Nominee AMA Number Nominee Club Affiliation Nominee AMA District * Please share why your copilot should be awarded the Copilot of the Year Award in 200-500 words. * Please upload a photo of your nominee in action Files must be less than 64 MB.Allowed file types: gif jpg jpeg png. Can the AMA Foundation share your copilot's photo on social media and the AMA Foundation website? * Yes No What mailing address would you like your nominee's Copilot Recognition Program certificate and letter sent to? * Would you like this nomination to be done anonymously? * Yes, please make my nomination anonymous. No, please ensure my nominee knows I nominated them. Would you like to customize your nominee's Copilot Recognition Program certificate and letter? If so, provide your customized note here. Personalized notes must not exceed 120 characters. Are you interested in sharing a video or written story about your copilot on the AMA Foundation's website and social media? * Yes, please contact me about sharing a written story or video about my copilot. No, I do not want to share a written story or video about my copilot. Leave this field blank
