Your Membership InformationYour Name* First Last Your Email* Your PhoneI would like to make a nominations for...* A. Gerald Shapiro, MD Award Practitioner of the Year Vendor of the Year Award A. Gerald Shapiro AwardThis prestigious award recognizes an individual of national prominence whose excellence and achievement have promoted respiratory care. It considers outstanding contributions by either a physician or other healthcare provider.Nominee Name* First Last Nominee Email Nominee PhoneNominee AARC NumberNominee CredentialsNominee AffiliationNational ContributionsAcademic or Scholarly ContributionsPeriodical PublicationsResearch ContributionsLeadership ContributionsVolunteer / Community InvolvementOther Contributions / Qualities The PHILIPS Respironics Excellence AwardThe Philips Respironics award recognizes an NJSRC member who has contributed significantly to both the NJSRC and respiratory care profession. Specific areas of achievement should include scholarship or academic contributions, periodical publications, research, leadership and voluntary efforts in the community involving the NJSRC.Nominee Name* First Last Nominee Email Nominee PhoneNominee AARC NumberNominee CredentialsNominee AffiliationState ContributionsAcademic ContributionsPeriodical PublicationsResearch ContributionsLeadership ContributionsVolunteer / Community InvolvementOther Contributions / Qualities Practitioner of the YearThis award recognizes a RCP who demostrates an extra commitment to their patients and who inspires and motivates other Respiratory Therapists. The practitioner must be working in a non-management capacity who provides the highest level of clinical practice. Recipient must be an AARC / NJSRC member.Nominee Name* First Last Nominee AARC NumberNominee CredentialsNominee Email Nominee PhoneNominee AffiliationYears in Profession< 5 years5 to 10 years10 to 15 years15 to 20 years20 to 25 years25 to 30 years> 30 yearsField of Specialty Adult Acute Care Continuing Care / Rehabilitation Education Specialty Home Care Long Term Care Neonatal–Pediatrics Management Diagnostics Sleep Surface & Air Transport Clinical StrengthsWorkplace ContributionsLeadership ContributionsVolunteer / Community InvolvementOther Contributions / QualitiesPersonal thoughts Vendor of the Year AwardThis award recognizes one company that actively supports respiratory care in the State of New Jersey by providing quality services, equipment or supplies and promotes and enhances professional development in the state.Company Name*Contact Person* First Last Contact Person Email Contact Person PhoneProducts or Services ProvidedWhy honor this company?Other Contributions / QualitiesNameThis field is for validation purposes and should be left unchanged.