Bernard E. Witkin Medal Application

Nominator Information

Nominator Name (First, Last)

Job Title

Employer

Email

Phone

Address (Street, City, State, Zip Code)

Nominee Information

Name of Nominee (First, Last)

Job Title

Employer

Email

Phone

Address (Street, City, State, Zip Code)

Why do you believe this person should be considered for this Award and what makes them special? (response in 500 words or less).
Describe here

The California Lawyers Association is committed to reflecting diversity, broadly defined, in all its activities. Please briefly (250 words or less) describe any characteristics, experiences or background, including traditional indicia of diversity, the nominee would represent.
Describe here

References

Names and contact information of two references who also support the nomination, not including the nominator

Reference One

Nominator Name (First, Last)

Job Title

Employer

Email

Phone

Address (Street, City, State, Zip Code)

Reference Two

Nominator Name (First, Last)

Job Title

Employer

Email

Phone

Address (Street, City, State, Zip Code)

Upload Supporting Document

Upload any supporting document to this application (PDF only)