The Jim Bouley Family Lifetime Award for Altruism Nomination Form
Nomination deadline: Friday, May 1, 2026.
Nominee information
Nominee name
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First name
Last name
Nominee NCRA member ID number
(If applicable)
Nominee home address
*
Street address
Street address line 2
City
State
Zip
Nominee phone
*
Please enter a valid phone number.
Nominee email
*
example@example.com
By selecting the box below, I have verified that the nominee is an NCRA member in good standing from among the following categories: Registered Member, Participating Member, Retired Registered Member, Retired Participating Member, or Retired Lifetime Member.
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Signature
Based on the above nomination criteria, how does/did your nominee demonstrate altruism throughout his or her career? Why does the nominee deserve this recognition? How does the nominee give back to their community?
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Cite examples. Note: Your nominee will be evaluated based on the information you provide. It is the only information that the NCRF Board of Trustees will have to make a determination. Be as specific as possible. You may use the field below to upload attachments.
Endorsement information
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Attach any forms of endorsement, such as letters, testimonials, etc.
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of
Number of years that the nominee has been a working captioner or reporter (minimum of 25 years)
*
Nominee’s bio (REQUIRED)
*
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You MUST attach the nominee’s bio.
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of
Nominator information
Nominator name
*
First name
Last name
Nominator home address
*
Street address
Street address line 2
City
State
Zip
Nominator phone
*
Please enter a valid phone number.
Nominator email
*
example@example.com
Please verify that you are human
*
Submit
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