2022 Innovative IT Award Nomination Form

Innovative IT Award Nomination Form

Nominations must be received by August 30 @ 5pm PST.
The Innovative IT Award recognizes the achievements and best practices in the creative use of automation to enhance the child support program. The innovative efforts of a IV-D agency or child support professional to implement technology solutions that create operational efficiency and ultimately improve child support services.
Nominee's Agency/Organization Name *
Please spell out acronyms.
Nominee's Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Nominee's E-mail *
Nominee's Phone Number *

Area Code Phone Number
Nominator:

Person submitting the nomination
Full Name *

First Name Last Name
Agency/Organization Name *
Job Title/Position *
E-mail *
Phone Number *

Area Code Phone Number
Nominee Information

Please indicate details about your nomination
Please list the name, organization and telephone number of one person who can confirm the information above and provide additional information about your nominee if requested by the Awards Committee.
Name *

First Name Last Name
Agency/Organization *
Phone Number *

Area Code Phone Number
This nomination can be drafted in regards to an improvement within your program that creates success around any of the services you provide. This might include:
- Innovations and implementation around the new federal rules;
- Successful efforts around federal performance measures;
- Critical and effective outreach efforts;
- Valuable collaborations with partners;
- Enhanced customer service approaches to our service recipients;
- OR… any other area within your program you deem to share relating an outstanding endeavor
Describe *
Provide, as needed, exhibits (e.g. charts, artwork, etc.) to illustrate the accomplishments of the program (no more than 5 pages)

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Innovative IT Award Nomination Form

Nominator:

Nominee Information