2012 H. SAMUEL KRUSE SILVER MEDAL FOR SERVICE/DESIGN Nomination NAMEAIA Member No. XXXXXXXXX Company/Title Address City, State Zip Phone/Cell Fax (optional) Nominators AIA Member NameAIA Member No. XXXXXXXXX

NOMINATION SUBMISSION Nominations should be submitted using this template and must include the following material and information: The nominator’s names and AIA membership number if nominated by five members. The nominee’s name, membership number, address, and phone and fax numbers with a photograph of the nominee suitable for press-release publication. A written statement about the nominee and their accomplishments summarizing why bestowing the Silver Medal upon the nominee fulfills the Award’s purpose, with sufficient documentation to substantiate and support the accomplishments. Exhibits and/or examples illustrating the nominee’s accomplishments in sufficient quantity to support award. Only electronic submissions will be accepted. Send by to File size of submission must not be larger than 10 megabytes.

A written statement about the nominee and their accomplishments summarizing why bestowing the Silver Medal upon the nominee fulfills the Award’s purpose, with sufficient documentation to substantiate and support the accomplishments. Please type your nomination statements in place of this text. This text is meaningless and is just here to show how it will fit on the page. Please type your nomination statements in place of this text. This text is meaningless and is just here to show how it will fit on the page.

Exhibits and/or examples illustrating the nominee’s accomplishments in sufficient quantity to support award.