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First/Last

Name:

Organization:

E-mail Address:

Date

Submitted:

Telephone:

Nomination for the following award:

Award

Nominee/Candidate

(First/MI/Last Name):

Brief background and description of reason candidate

is being nominated for award. List committee

name(s) and study title(s) as they should be listed in

the Awards Brochure

Qian Graves FDA

qian.graves@fda.hhs.gov

3/5/2013 240-402-1837 7. Technical Advisor of the Year

Robert LaBudde

Technical Advisor