Vita et Caritas Award

Vita et Caritas Award

Nomination Application
Nominator Information
Date*

MonthDayYear
Date
Name*

First NameLast Name
Title*
Email*
example@example.com
Phone Number*

Area CodePhone 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*

Area CodePhone Number
Organization Address*

Street Address

Mailing Address

CityState / Province

Postal / Zip Code
Describe the main work of the organization.*
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 NameMiddle NameLast Name
Address*

Street Address

Mailing Address

CityState / Province

Postal / Zip Code
Nominee Phone Number*

Area CodePhone 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.*
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 NameLast 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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Vita et Caritas Award

Nominator Information

Nominating Organization

Nominee Information

Disclaimer and Signature