Connie Kaiser Restorative Justice Award Nomination Form

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The Connie Kaiser Restorative Justice Award is presented to the person, program or Detention Center that exemplifies the highest standards of the profession in the area of promoting restorative justice principles, practices, and activities for youth in Detention. This award is selected by the Awards Committee.

Nominees Name (Please spell the nominees name as it should be spelled on the award) *

Nominee's County/Department *

County/Department's Address *

County/Department's Phone Number *

Nominee's Email Address *

Nominee's CMO/Director's Name and E-mail *

Is the CMO/Director aware of this nomination? *

Yes

Unsure

List the nominee's specific contributions to the field of detention. *

List the nominee's years of service, education, professional advancement, and community involvement *

List the nominee's professional affiliations *

List nominee's publications, writings, awards, recognitions, etc.

Discuss the nominee's dedication to promoting restorative justice principles, practices, and activities for youth in detention. *

Name of Detention Center nominee serves *

Provide any additional information which explains why the nominee should receive this award. *

Submitted by: (Name) *

Submitter's County/Department *

Submitter's Title/Position *

Submitter's Phone Number *

Submitter's Email Address *

Date Submitted *

YYYY

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