32nd Annual Mother's Day Nomination Form

34th Annual Mother's Day Luncheon Nomination Form
Our mission is strengthening families and improving birth outcomes in the underserved community within Broward County through comprehensive programs, education, and access to vital support services.

For more than 33 years, Healthy Mothers, Healthy Babies Coalition of Broward County has proudly recognized exceptional members of our community who exemplify outstanding parenting while making meaningful contributions to improving the lives of women, children, and families throughout Broward County.

We invite you to nominate an individual whose dedication, leadership, and commitment have positively impacted our community and whose actions reflect the values of compassionate parenting, service, and advocacy.

Please take a few moments to complete this application, which is designed to highlight the accomplishments, community involvement, and contributions of an individual deserving of the distinguished honor of being named Healthy Mothers, Healthy Babies Coalition of Broward County's 2027 Outstanding Mother or Father of the Year.
Criteria for Recognition
- Exemplifies the qualities of outstanding parenthood, such as kindness, caring, sacrifice and generosity to children
- Makes a difference through their civic engagement, philanthropic activity, and charity work in Broward County
- Demonstrates exceptional leadership, vision, inspiration, innovation, and compassion while positively impacting the Broward County community
- Presents traits and accomplishments aligned with Healthy Mothers, Healthy Babies mission
- Lives/works in BrowardCounty
- Is a mother, father, stepparent, adoptive parent. or foster parent
Nomination Deadline: August 15, 2026
Nominated By

Your First NameYour Last Name
Your Email
example@example.com
Your Cell Phone Number

Area CodePhone Number
Your Relationship to the Nominee
(ex. family, friend, colleague, etc.)
Nominee Information

Please complete Nominee's information.
Nominee Name

PrefixFirst NameLast Name
Nominee's Company or Organization
Business Name or Organization Name
Nominee's Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Nominee's Email Address
example@example.com
Nominee's Personal Cell Phone Number

Area CodePhone Number
Number of Children
Current Non-Profit Leadership Roles And/Or Other Current Non-Profit Roles
(ex. Board of Directors, Executive Director, etc.)
Past Non-Profit Affiliations
(ex. Volunteer, Event Chair, etc.)
How has your Nominee's volunteer and philanthropic efforts made a difference in the community?
(ex. community involvement, non-profit affiliations, board positions, etc.)
* Any item marked with an asterisk must be filled out otherwise the form cannot be submitted. All requested information must be completed before a nominee will be considered by the Nominating Committee.
If you have any questions, please contact Dawn Liberta | 561-628-0994 | dliberta@hmhbbroward.org

34th Annual Mother's Day Luncheon Nomination Form

Criteria for Recognition

Nomination Deadline: August 15, 2026

Nominee Information