Arizona Branch AALAS

Dedicated to the advancement of responsible care and use of laboratory animals for the benefit of human and animal health

2021 Technician of the Year Nomination Form

ARIZONA BRANCH OF AALAS
2021 NOMINATION FORM FOR TECHNICIAN OF THE YEAR

Nominees must be a member in good standing of AZAALAS who:

Participates in the AALAS Certification process
Assists in training of fellow technicians
Promotes and participates in continuing animal care related education
Suggests ideas to alleviate animal distress, enhance facility management, and
Actively encourages animal welfare in research
Participates in the local and national organizations and volunteers to work on committees
Recognizes others contributions of others and nominates for committees and awards
Demonstrates a positive attitude and dedicated approach to the betterment of animal care through technical performance and education
Encourages active participation within the branch and works diligently to meet deadlines regardless of other daily obligations
Volunteers to assist fellow members and provide support when needed
Seeks education through meeting attendance, paper and poster submissions

Name of Nominee *

Job Title *

Place of Employment *

Years as a member of AALAS

Arizona Branch

National

Level of Certification to Date

Please Specify Certification Type

Educational Background:

High School and Diploma/Degree

College and Diploma/Degree

Graduate School and Diploma/Degree

Other

Special Courses

Years Working with Laboratory Animals or in the Laboratory Animal Field

Describe Nominee's Participation in the Animal Care Field Outside of Work (ie. docents at the zoo, presenting papers at meetings, teaching training sessions, clubs, memberships, etc.)

Proficiencies (accomplishments, contributions, continuing education, AALAS participation, etc.)

Reasons why you feel this person should be considered for this award

Evaluation by immediate Supervisor (consider aspects such as character, personal habits, interest in advancement of self and animal care, job efficiency, and overall knowledge of laboratory animal science)

Supervisor Information

Name *

Phone *

Email *

Reference 1

Name *

Phone *

Email *

Reference 2

Name *

Phone *

Email *

Reference 3

Name

Phone

Email

Nominations must be submitted no later than September 15, 2021 at 5:00pm.

If you have any questions, please contact azaalas@gmail.com

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2021 Technician of the Year Nomination Form