2017 Annual Awards
Thank you for taking the time to nominate our 2017 Healthy Start Annual Award Winners!

It is our tradition each year to recognize those in the community who have gone "above and beyond” to help us achieve our mission. We appreciate your help in helping us chose these award winners. Please review the attached nomination forms and the criteria for each, and submit your recommendations.

Please set aside about 10-15 minutes to complete this nomination form. We ask that you please fill out the appropriate form for each submission to the best of your ability. Please feel free to leave any category blank if you do not have a nomination.

Award Winners will be announced and recognized at our 2017 Annual Meeting, to be held on Friday, September 15th, at the Laurel Oak Country Club. For more information, visit: http://healthystartsarasota.org/breakfast-of-champions/

Award Categories:

Lawtown Chiles Award
Mission Award
Volunteer of the Year
Community Partner of the Year
Media Partner of the Year
Business Partner of the Year
Family of the Year (*For Healthy Start Care Coordinators and Wrap-Around Service Providers)

Thank you for your support!

1. Nominations Submitted By: (Name, Agency)
Your answer
2. Mission Award - Name and Describe the individual whose work has been of sustained, significant value in helping to achieve our mission: “To promote the health and well-being of pregnant women, infants, and young children."
Your answer
3. Lawtown Chiles Award - Name and Describe the individual whose long-term contributions to prenatal, maternal, and early child health in Sarasota County are characterized by exceptional commitment, wisdom, leadership, and vision.
Your answer
4. Volunteer of the Year- Name and Describe a Healthy Start Volunteer who's contributions or achievements have been of significant support to families during pregnancy and/or their child's first three years.
Your answer
5. Community Partner of the Year- Name and Describe the Community Organization/Individual whose work with the Healthy Start Coalition, Healthy Start Program, MomCare Program, or Fetal and Infant Mortality Review Project has been of sustained, significant value in helping to achieve our mission: “To promote the health and well-being of pregnant women, infants, and young children.”
Your answer
6. Media Partner of the Year - Name and Describe the Media Organization or Person whose work with the Healthy Start Coalition, Healthy Start Program, MomCare Program, or Fetal and Infant Mortality Review Project has been of sustained, significant value in helping to achieve our mission: “To promote the health and well-being of pregnant women, infants, and young children.”
Your answer
7. Business Partner of the Year - Name and Describe a Business Partner that has contributed resources, in-kind, or financial support to the Healthy Start Coalition to enhance services for pregnant women and young children.
Your answer
8. Family of the Year (*For Healthy Start Care Coordinators and Wrap-Around Service Providers) - Name and Describe a family which has excelled and was successful in adopting behaviors, making life changes, showing love and compassion, etc., to have a healthy pregnancy; and how they/she provided positive parenting to promote the health and well-being of the baby.
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms