Stephenie Foster Advocate of the Year Award Nomination Form

Nomination Form

Complete the form below to nominate someone or to self-nominate for the Advocate of the Year Award
Award Parameters
- Must be a U.S. Resident
- Demonstrated action fighting for women and girls through a program, initiative or individual leadership
- While work conducted on behalf of large organizations is admired and critical, this particular award gives precedence to individuals advocating without resources and support normally granted to larger entities
Submitter Information
Your Name*

First NameLast Name
Email*
example@example.com
Phone*
Please enter a valid phone number.
Where did you hear about Stephenie Foster Advocate of the Year Award? (Facebook or other Social Media, Colleague, Friend, Organization, etc.)
Would you like to be subscribed to the Take Action Newsletter?*

Yes, sign me up!No, thank you.
Nominee Information
Name of Nominee*

First NameLast Name
Organization*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Linked In Profile
Website
Other Social Media Profiles

How would you categorize the nominee's work?*

EducationDomestic ViolenceEconomic OpportunityPolicy / Public OfficeOther
If "other" please specify, or write N/A*

Tell us more about the impact the nominee's work has had in their community and within their organization.*
What is the best estimate on how many individuals have been impacted by the nominee's work?*
What obstacles, roadblocks or challenges has the nominee faced and how have they overcome them?*

What makes this person a strong leader and advocate in the fight for women & girls? Include three leadership strengths embodied by the nominee.*
What else do you want us to know about the nominee that is not previously reflected in any of your answers?
Upload any examples of the nominee's work or achievements.

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Nomination Form