Michigan Insurance Hall of Fame

Nomination Form

The Nominee should be recognized within the Michigan insurance and risk management industry as a leader and/or innovator who has made significant contributions to the success of the industry, its perpetuation and its ability to serve the public.   These contributions should reflect effort and accomplishments over and above the requirements of a job description.  The criteria identified below are offered as guidelines and as such are not expected to be all-inclusive.  At the discretion of the election panel, nominations based on factors not described here but deemed appropriate by the panel are eligible for consideration.  Nominees that are deceased may be honored posthumously.

Supporting documentation should be attached to assist the nomination committee in their selection process.
This may include letters of support and/or articles about the nominee.

 Please provide the following information in a similar format as a cover page; you need not use this actual form.

 

Nominator's Name                                                                                                                   

Home Address                                                                                                              

            Work Address                                                                                                              

            Home Telephone                                                Work Telephone                        

Nominee's Name                                                                                                                       

            Home Address                                                                                                              

            Work Address                                                                                                              

            Home Telephone                                                Work Telephone                        

 

We will contact the nominator regarding the results of the selection process.

We will not contact the nominee unless approved for induction into the Michigan Insurance Hall of Fame.

 

Please describe the nominee’s achievements in one or more of the following areas of contribution:

Creation or implementation of a product, service, program or communication innovation that has had a outstanding impact on the ability of the industry to better serve and/or protect the public:

 

 

 

 

 

 

 

 

 

 

 

Development or implementation of a meaningful improvement in the level of knowledge and education within the industry which has positively impacted its ability to effectively serve the public and successfully address future needs:

 

 

 

 

 

 

 

 

 

 

 

Provided significant support in attracting and/or developing new participants to the insurance and risk management industry through the efforts of professional organizations, college/university programs, internships and like activities to assure industry professionalism and perpetuation:

 

 

 

 

 

 

 

 

 

 

 

Influenced or played a significant role in the development of legislative and/or regulatory activity related to the ability of the industry to succeed in Michigan’s unique insurance environment while serving and/or protecting the public:

 

 

 

 

 

 

 

 

 

 

 

Provided exemplary service to the public in any role or circumstance not described above that has reflected positively on the insurance and risk management industry and its ability to serve and protect the public:

 

 

 

 

 

 

 

 

 

 

  

Submitted materials will be kept confidential and become the property of the Michigan Insurance Hall of Fame.

DEADLINE FOR NOMINEE CONSIDERATION IS MARCH 1.

For consideration, return this nomination form or reasonable facsimile and all supporting documents along with payment of $250 to:

 Michigan Insurance Hall of Fame
The Risk Management and Insurance Center at Olivet College
320 South Main Street
Olivet, Michigan  49076

 

Please circle one:    American Express      Master Card      Visa      Discover            Amount to be charged: _____________

Card # ____________________________________   Expiration Date ____/____   Security Code (back of card) _________

Signature _____________________________________________________

Your credit card charge will be processed through Olivet College and "Olivet College" will appear on your statement.

A selection panel of professionals from a cross-section of the insurance and risk management community will review the nominations and vote to induct up to three new members. Any candidate not inducted in the first year of consideration is automatically reconsidered in the second year (additional supporting material would be welcomed). 

Thank you for supporting the Michigan Insurance Hall of Fame, which was established in 1994 to recognize the outstanding contributions of insurance and risk management professionals, and to support insurance scholarship and research.