Excellence in Charity Award 2020 Nomination Form

Submission Deadline For 2026: [Date: Friday, June 5, 2025]

Thank you for taking the time to nominate an individual in your organization for this year’s Community Rebirth Impact Award.

The Community Rebirth Impact Award honors individuals who embody compassion, resilience, cultural care, and community uplift.
Nominees may be advocates, caregivers, mentors, survivors, youth leaders, or community members whose impact has strengthened the village.

Please complete the form below to nominate someone who reflects the mission and values of The Community Rebirth Foundation, Inc.

please email info@communityrebirthfoundation.org with any questions.

All nominations are confidential.

Qualifications: The nominee must

Demonstrate a clear and positive impact on their community
Embody compassion, cultural awareness, and integrity
Support, uplift, or advocate for individuals within BIPOC communities
Have made an impact within the last 12–24 months (formal or informal).
Be willing to allow their story to be shared if selected

To complete the nomination, please complete a brief description for at least three of the following six characteristics that support how the individual has demonstrated that characteristic:

Compassionate
Leadership

Advocacy
Mentorship

Resillence
Spiritual Support

NOTE: As you provide information, please be mindful to not disclose any personal details of those who the nominee has served.

YOUR INFORMATION

Your Name*

First NameLast Name

Email (optional)

example@example.com

NOMINEE'S INFORMATION (For Organizations)

Nominee's Name

First NameLast Name

Nominee's Status with Organization

Paid EmployeeVolunteer

Organization's Name

Nominee's Position with Organization

NOMINEE'S INFORMATION (For Individuals)

Nominee's Name

First NameLast Name

CHARACTERISTICS

COMPASSIONATE -Describe how the nominee shows kindness, emotional presence, and genuine care for others.

LEADERSHIP - Share an example of how the nominee leads, guides, or inspires those around them.

ADVOCACY- Explain how the nominee speaks up for others, supports marginalized voices, or fights for community needs.

MENTORSHIP- Describe how the nominee supports, guides, or pours into others through teaching, encouragement, or lived experience.

RESILLIENCE- Share how the nominee has shown strength, perseverance, or courage in the face of challenges.

SPIRITUAL SUPPORT- Explain how the nominee offers spiritual grounding, prayer, wisdom, or emotional covering to others.

Please provide any further support you might have for how this individual exemplifies principles of true charity.

Community Rebirth Impact Award — Nomination Form