Request Content Submission New York / NYSARH / Request Content Submission If you are a NYSARH Member looking to add content or opportunities, fill out this brief form so that we can best organize and design your content in the most effective way. 1 Nominee Information 2 Brief Summary 3 Your Information Nomination Category This nomination is for the following category: (Please select one) Senator McGee Award Dr. Gary Ogden Rural Health Practitioner of the Year Outstanding Rural Health Program Nominee Information Nominee Name: Phone Organization (If employed): If nominee is an organization, list contact person and title Contact Person: Title: Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Rural area affected by project: If nominating a collaboration, please name all partners and their roles: References Names and contact information for three references Name: Phone Email Name: Phone Email Name: Phone Email Brief Summary Please provide a brief summary (500 words or less) of why you believe this individual, organization or program should be nominated. Your details Name: Phone Email