2020 HMHBGA Carolyn Wetzel Award Nomination Form
The Carolyn Wetzel Continuum Award recognizes volunteers and health professionals who contribute to the health and well being of Georgia's families. This award is in memory of Carolyn Wetzel, a long-time member, friend, and dedicated public health advocate for mothers and babies.

The ideal nominee exhibits these characteristics:
• Role model for peers
• Demonstrated commitment to achieving equity in healthcare for Georgia’s women and children
• A positive change agent in the public arena of advocacy and policy

This award will be presented during our Annual Meeting & Conference which will be virtual this year. More at: http://hmhbga.org/event/beyondcovid2020/

Questions? Call 770-451-0020.

DEADLINE TO SUBMIT: July 15, 2020.
This year's Wetzel Award Reception is Sponsored by:
Nominee (Individual or Organization) *
Nominated By (Your Name) *
Nominee's Address *
Nominee's Work Phone
Nominee's Personal Phone
Nominator's Phone (Your Phone Number) *
Nominee's Occupational and/or Volunteer Accomplishments: *
How does this candidate serve as a role model for peers? *
How does this candidate demonstrate commitment to achieving equity in healthcare for Georgia’s women and children? *
Carolyn Wetzel was deeply involved in affecting policy change throughout her career. How does this candidate serve as a positive change agent in the public arena of advocacy and policy? *
Can you help us assure that this nominee, if selected, will attend the virtual award presentation on October 28, 2020? *
Your Electronic Signature *
Submit
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