Neil Campbell Recovery Champion Award Georgia School of Addiction Studies 2024
In recognition of accomplishments to the Georgia Recovery Community, the Georgia School of Addiction Studies will present an individual with the Neil Campbell Recovery Champion Award:
The Neil Campbell Recovery Champion Award
The award will be presented at the 2024 Georgia School of Addiction Studies, Wednesday afternoon treatment luncheon on August 28, 2024,at Hyatt Regency Hotel in Savannah, Georgia. Nominations may be made by completing this form. Nomination form(s) must be received no later than close of business July 21, 2024.
Nomination Criteria:
Nominee should be active in the Georgia Recovery Community. The award will be based on the individual's accomplishments during the past year and general accomplishments in treatment over their organizational existence. Winner will be notified prior to luncheon and is required to attend to receive the award. The person making this nomination will be asked to co-present the award at the Georgia School on August 28, 2024
Application Instructions/Criteria
Complete the following JotForm by July 21, 2024. No attachments accepted. Deadline is close of business (5pm) July 21, 2024. The person making this nomination will be asked to co-present the award at the Georgia School on August 28, 2024. You will receive a reply/notification upon our receipt of the nomination form.
The Neil Campbell Recovery Champion Award Nominee Form
17th Annual Georgia School of Addiction Studies 2024
Reason For Nomination
Explain why your nominee deserves the selected award.
Nominee Information
Nominee's Organization
Nominee's Name
First Name
Last Name
Nominee's Work Phone Number
Nominee's Cell/Home Phone Number
Nominee's E-mail Address
example@example.com
Nominee's Agency/Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nominee's Home Address (if known)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
1) Brief biography/background of person nominated:
2) List nominee's Accomplishments/Contributions in the Past Year to Georgia's Recovery Community. (Include a description of the types of activities, the continuity of the activities (i.e. is this a one time activity or ongoing), number of populations reached, materials developed, innovations, outcomes, collaborations, and impact on the community):
3) List of nominee's Other Accomplishments/Contributions over their past three years in Georgia's Recovery Community. (Can include their development and implementation of treatment programs/services, a description of their contributions to treatment advocacy, collaboration, professional development, number of populations reached, and service on boards, committees, or coalitions):
4) A summary statement of why this person should receive the award.
5) Nominee's approximate length of time in the Georgia Recovery Community
6) Is a representative available on 8/28/2024 to receive this award?
Yes
No
Your Information
Your Name
First Name
Last Name
Your E-mail Address
example@example.com
Your Phone Number
Send Nomination
Should be Empty: