2021 Celebration Awards Nomination Form

Hosted by: Celebration Awards Committee of Lehigh & Northampton Counties

March 25, 2021 | 3:30 PM - 5:00 PM
This year’s event will be virtual!

This event was developed to recognize March as Developmental Disabilities Awareness Month in Pennsylvania. Just about every day, individuals with disabilities accomplish amazing things, and this is our chance to honor their achievements!

To be eligible for a Celebration Award, a person must meet the following 2 criteria:

Currently diagnosed with an Intellectual and/or Developmental Disability (I/DD);
Must receive a disability-related service in either Northampton or Lehigh County. This may include Support Coordination, Waiver funding, FD/FSS funding, Special Education, etc.

Awards are given to individuals with I/DD who have demonstrated success in one of the six areas listed below. Individual awards for achievements are given to a person from Lehigh County and Northampton County!

All nominations must include a brief narrative describing the reason for the choice and the name/contact information of the person making the nomination.

If you want to nominate an individual in more than one category, please select all awards that apply in the checklist.

ALL NOMINATIONS ARE DUE BY JANUARY 31, 2021!

The Education Achievement Award is presented to an individual who has made significant educational progress, is motivated to learn, and is a positive influence on others.

The Employment Achievement Award is presented to someone who has been successfully employed with or without supports over the past year. This may include someone who has made great progress over the past year, has acquired a new skill, attained a new position/promotion, has good attendance, and has a positive attitude about work.

The Exemplary Citizenship Award is presented to someone who has volunteered or made contributions to their family, school, or community, specifically with actions that put others first.

The Personal Achievement Award is presented to individuals who have made great strides in reaching personal goals and who have enriched their own capabilities.

The Transition Achievement Award is presented to someone who has successfully mastered a life transition, which may include transitioning after high school or between different living situations, etc.

The Self-Advocacy Achievement Award is presented to someone who has advocated to make a positive difference in their life and the lives of others.

Name of Nominee *

First Name Last Name

Nominee Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Nominee Contact Email (If Available)

example@example.com

Nominee Phone Number *

Area Code Phone Number

County where the nominee receives services *

Lehigh Northampton

I am nominating this person for the following award (please select all that apply): *

The Education Achievement Award The Employment Achievement Award The Exemplary Citizenship Award The Personal Achievement Award The Transition Achievement Award The Self-Advocacy Achievement Award

Reason for Nomination: *

Please include information on what makes the person stand out in a positive way and why you feel they deserve this award. If you are submitting for more than one award, please indicate your reasoning for each award. Please be as detailed as possible!

Nominator's Name *

First Name Last Name

Nominator's Email *

example@example.com

Nominator's Phone Number *

Area Code Phone Number

Relationship to Nominee *

Parent/Family Member Supports Coordinator Education Personnel (Principal, Guidance Counselor, Teacher, etc.) Agency/Program Staff

Questions? Please email Celebration.Committee.15@gmail.com

2021 Celebration Awards Nomination Form

Award Criteria

Award Descriptions

Nomination