To nominate an individual for the Scholarship, please complete the form below. Only one nomination per eye bank will be accepted. The nomination deadline is November 10. "*" indicates required fields Nominee's InformationNominee Name:* First Last Job Title:* Eye Bank:* Phone:*Email:* Nominated By:* How long has this individual been involved with the eye bank?:* Why should this individual receive the Jachin Misko Memorial Scholarship for Technical Advancement in Eye Banking? (50-100 words):*How will this person benefit from attending the EBAA Technician Education Seminar? (50-100 words):*How has this individual helped to drive innovation in your eye bank? (50-100 words):*Describe how this individual has demonstrated leadership skills within your eye bank (50-100 words):*What are your expectations about this individual's future career in and contributions to eye banking? This can include work at the eye bank and the association. (50-100 words):*Nominee's Personal StatementPlease include a statement by the candidate stating personal objectives for the seminar and the reason(s) he/she would benefit from attending the seminar.Personal Statement*Accepted file types: word, pdf, doc, docx, , Max. file size: 25 MB.Nominee's HeadshotIf available, please submit a headshot of the nominee.Headshot*Accepted file types: jpg, pdf, png, Max. file size: 25 MB.