Award Nomination Form
We are providing awards to persons in the field of developmental disabilities who stand out due to their exemplary commitment, compassion, and advocacy. Please share an example or two in each of the following categories regarding the nominee:
Nominee Name
*
First Name
Last Name
Nominee Phone
Please enter a valid phone number.
Agency Name
*
Agency Location
*
Nominee Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Your Name
*
First Name
Last Name
Your Preferred Contact Number
*
Please enter a valid phone number.
Your Email
*
example@example.com
How has the nominee improved the quality of life of a person or persons served?
How has the nominee served as an advocate for the field of developmental disabilities?
What activities does the nominee engage in that enhance the lives of people served?
List three words to describe the nominee's strengths.
Cost saving initiatives
Quality improvements
Creative Initiatives
Safety
Leadership Initiatives
Person-centered approaches
Any additional information or details regarding the nominee’s attributes that make him/her the most deserving for this recognition. Specific examples will help support the nomination.
Submit
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