Nomination Form - S.M.I.L.E. Award
Sustained Mental Health Initiatives and Lifetime of Excellence
Nominator Name?
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First Name
Last Name
Nominator Email
*
example@example.com
Nominator Phone/Text
*
Please enter a valid phone number.
Personal Social Channel
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Are You Nominating a Person or Business?
Please Select
Business (for profit)
Organization (nonprofit)
Individual
Company or Organization Name (if applicable)
Nominee Name or contact? (self nominations accepted)
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First Name
Last Name
Nominee Contact E-mail
*
example@example.com
Nominee Phone Number
Please enter a valid phone number.
US State Nominee is Located
*
Social Channel(s) of Nominee (Personal or Corporate)
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Number of Employees (if Business or Organization)
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Why is Nominee a Champion of Mental Health ?
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0/500
Describe the Nominee's initiatives, practice or activities that builds or advocates for mental health for youth.
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0/500
Please Provide 3 Links that Showcase and Supports Your Nomination:
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What Can You Do to Add Your Support to Choose Mental Health?
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How Did You Hear About this Award?
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