We use cookies on this website to give you the best experience and measure website usage. By continuing to use this website, you consent to these cookies. For more information, view our cookie policy page.
Page hero image

Stars of Life Nomination Form

General Information

The Stars of Life Program offers a unique opportunity for GMR to bring national recognition to our employees and our company. This year, part-time and full-time nurses, paramedics, EMTs, communication center employees and other front-line professionals, who meet the selection criteria (as described in "Eligibility and Selection Criteria" section below), may be nominated for a Star. The qualities and achievements for which the Star is selected should be consistent with GMR's Mission Statement and Guiding principles.

GMR will send another group of deserving "Stars" to the American Ambulance Association (AAA) Stars of Life Program in Washington, D.C.

The AAA Stars of Life celebration is the nation’s most prestigious event to recognize and honor dedicated EMS professionals. The program features meetings with members of Congress on Capitol Hill. The Stars themselves deliver important information to their U.S. representatives and senators on the value of quality ambulance services as an essential component of an effective and efficient healthcare system. By sponsoring our Stars and joining other AAA members at the event, we gain a tremendous national platform to educate our elected officials about our many entrepreneurial solutions to healthcare public policy challenges. Your participation also ensures wonderful memories for our employees and valuable local recognition. This exposure enhances the profile of National EMS Week across the United States.

GMR will cover travel and banquet expenses for the Star.

Completion of all of the fields below is required and should be done as accurately as possible. If you need assistance in obtaining the required information, please work with your Regional Director, General Manager or local HR representative. The following information is critical in establishing contact with the nominee if he/she is chosen as a Star of Life.

There is an option at the end of the form to upload supporting documentation, photos, letters.

ELIGIBILITY AND SELECTION CRITERIA
SCORING
The GMR Mission

Please provide the following information about the NOMINEE:

 
Organization:

Please provide NOMINEE'S BUSINESS CONTACT INFORMATION:

 

Please provide NOMINEE'S HOME CONTACT INFORMATION:

 
 
Was this person previously nominated?:

Please provide the following information about the NOMINEE'S OPERATION:

Please provide the following information about you, the NOMINATOR, in case we have any follow-up questions:

1. Describe the reason(s) this individual is being nominated by describing his/her commitment to GMR's mission and guiding principles.

(200 characters or more)

2. Describe his/her specific contributions in to the EMS profession that you believe should be recognized. Provide as much detail as possible about the “who, what, where, when, why and how” of this person’s contributions. Examples include, but are not limited to:

  • participation in a noteworthy "save"
  • voluntary EMS related community service
  • significant support for colleagues
  • initiative taken to launch or promote efforts to improve clinical expertise
  • role as a mentor for new EMTs, paramedics, nurses
  • unique support for patients going "above and beyond" normal service that displayed true commitment to Global Medical Response's Mission - Providing care to the world at a moment's notice
(200 characters or more)

3. Why do you believe this individual will be a superb representative for GMR and the AAA during the Stars of Life event in Washington, D.C.? (Remember: Stars meet with members of Congress and play a major role during local EMS week celebrations)

(200 characters or more)

4. Describe a distinguishing personal trait.

(200 characters or more)

5. Describe work experience; how long has he/she been in EMS? Did he/she seek additional credentials? To your knowledge, has this person continued his/her professional education?

(200 characters or more)

6. Describe notable personal interests (i.e. hobbies, personal contributions to the community).

(200 characters or more)

7. Is there anything else you would like us to know about the individual that you have not already included?

If you have any supporting documentation - photos, letters, thank you cards, news articles - please upload here:

 

if you need to upload more files, consider adding multiple files into a zip file and upload .zip file instead.