Vita et Caritas Award
Nomination Application
Nominator Information
Date
*
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Month
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Day
Year
Date
Name
*
First Name
Last Name
Title
*
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
How did you hear about this award?
*
Nominating Organization
Organization Name
*
President/Executive Director
*
President/Executive Director Email address
*
example@example.com
Organization Phone Number
*
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Area Code
Phone Number
Organization Address
*
Street Address
Mailing Address
City
State / Province
Postal / Zip Code
Describe the main work of the organization.
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Geographic area served
*
Year founded
*
Number of employees
*
Describe how organization serves women, children, and/or families.
*
Include any other information that supports your nomination.
*
Nominee Information
Name
*
First Name
Middle Name
Last Name
Address
*
Street Address
Mailing Address
City
State / Province
Postal / Zip Code
Nominee Phone Number
*
-
Area Code
Phone Number
Nominee Email
*
example@example.com
Nominee volunteer position in organization
*
How long has Nominee been a volunteer in organization?
*
Other volunteer positions in organization and recognition given Nominee.
*
Describe Nominee's responsibilities.
*
Describe how Nominee contributes to organization's mission fulfillment.
*
Describe how Nominee helps better the lives of women, children, and/or families.
*
If you have any additional materials that allow us to learn more about the work of this nominee, we encourage you to please attach them.
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Disclaimer and Signature
I certify that I have permission from the nominee to submit this application. I also certify that if the nominee is selected, he/she will appear at the Bishop’s Summer Reception to accept the award.
Your Name
*
First Name
Last Name
Please feel free to submit any additional documents or recommendations. Click on the "Browse Files" button below to attach your documents.
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