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Prevention Award Nomination
As the nominator, do you wish to remain anonymous?

Your Information

Name
Name
First
Last
Address
Address
City
State/Province
Zip/Postal
If requested, can we share your name with the nominee?

Nominee's Information

Name
Name
First
Last
Address
Address
City
State/Province
Zip/Postal
Are they an individual, coalition, prevention provider, SAP team, youth coalition, faith-based organization, advocate, commissioner, coalition member, etc.
0 of 50 max words
Select one of the following award categories that best represent your nominee.
  • Provide a high-level overview of your nominee, highlighting their significant contributions and impact in their respective field or area of focus.
  • Kick off your nomination with an impactful story or message that shows us who you're talking about.
  • Describe the person/group, what they do, and why it matters. Make it clear and straightforward, so we have a practical understanding of your nominee right from the start. This way, your nomination will grab attention and make an impression!
0 of 200 max words
  • In this section, we encourage nominators to provide details and examples of their nominee's achievements (use the points, under the award categories, in the nomination form as a guide)
  • Feel free to share notable accomplishments and highlight the impact your nominee has made in their respective field or area of focus.
0 of 250 max words

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