Engaged in Action Award Nomination Form

Engaged in Action Award Nomination Form
Engaged in Action Award Criteria & Definition
Any nominee must reside in (individuals)/serve (organizations) in Douglas County and exemplify the values of Engage Douglas County:
- Demonstrated commitment to reducing substance misuse and suicide and/or promoting mental health
- Active engagement in issues that affect residents in Douglas County, such as drug and alcohol use, suicide prevention, or other behavioral health issues
- Dedication to serving the Douglas County Community
Awards will be presented at a ceremony on June 25th, 2026. Nominations for this year's Engaged in Action Award will be due by May 15th, 2026.
Nominee Type
Name of Person or entity being nominated
Nominee's Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Nominee's Email*
example@example.com
Please provide a brief narrative (2-3 sentences) regarding the reason for your nomination.
Nominating Entity or Person
Nominating Email
example@example.com
Nominating Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
How did you hear about Engaged in Action?
YesNo
Comments?
Should be Empty: