2018 CCAI Angels in Adoption® Community Nomination Form
Do you know someone who is an adoption/foster care advocate and is making/has made an extraordinary contribution(s) for adoption and/or foster care? In particular, in what notable way(s) have they made an extraordinary contribution to adoption/foster care beyond adopting and fostering a child or children? Would you like to honor them for how their experience and action set them apart from others? Nominate them as an Angels in Adoption® Honoree!
INFORMATION OF THE PERSON COMPLETING THIS NOMINATION FORM
First Name of person completing this form: *
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Last Name of person completing this form: *
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Email Address of person completing this form: *
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Phone Number of person completing this form: *
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NOMINEE INFORMATION
Is your Nominee a(n): *
First Name(s) of Nominee OR point of contact, if an organization: *
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Last Name(s) of Nominee OR point of contact, if an organization: *
Your answer
Nominee Organization (if applicable):
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Nominee Street Address: *
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Nominee City: *
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Nominee State: *
Nominee Zip Code: *
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Nominee primary phone number: *
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Nominee secondary phone number: *
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Nominee email address: *
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MEMBERS OF CONGRESS INFORMATION
The Nominee's U.S. Senators and U.S. Representative must be listed and spelled accurately in order for this community nomination form to be sent to their office. Please take great care to properly spell their name when you submit this information. To find the Nominee's U.S. Senators and U.S. Representative, please visit www.whoismyrepresentative.com.
U.S. Senator 1 First Name: *
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U.S. Senator 1 Last Name: *
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U.S. Senator 2 First Name: *
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U.S. Senator 2 Last Name: *
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U.S. Representative First Name: *
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U.S. Representative Last Name: *
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NOMINEE'S CONTRIBUTION TO ADOPTION/FOSTER CARE:
In this paragraph, you are encouraged to include how your Nominee came to be an advocate in the adoption and/or foster care field, their adoption and/or foster care journey, and, in particular, any notable work or ways they have made an extraordinary contribution for adoption/foster care. We encourage you to supply information that takes your Nominee beyond adopting and fostering a child or children. How has their experience and action set them apart from others for this national honor? To be accepted, the paragraph must be a minimum of 200 words and no more than 300 words.
In what way(s) has your Nominee made an extraordinary contribution on behalf of children who need families through adoption and foster care? *
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Please copy, paste, and label the link(s) to any media attention the Nominee has received.
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Please take a moment to share any special notes/instructions for this nomination:
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The Angels in Adoption® Program is a signature program of the Congressional Coalition on Adoption Institute and is celebrating its 20th year of impacting Capitol Hill on behalf of children who need families.
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