Champions of Central Nomination Form
Nominations due: Wednesday, October 25, 2023
Winners notified: November 8, 2023

**Save the Date**
Awards presentation & community meeting: November 16, 2023
Sign in to Google to save your progress. Learn more
Criteria for Nomination (Nominee should meet at least three)
Central Resident

- Serves as a leader in the Central community
- Serves as an ambassador in a partner organization for programs or projects that directly impact the Central community
- Serves as a Cleveland Central Promise Ambassador
- Has made a significant impact in the Central community by way of leading or participating in an activity or program in the area(s) of health, education and/or advocacy

Community Partner Staff

- Demonstrates a passion for the Central community
- Demonstrates commitment to the mission and vision of the partner organization
- Continuously goes above and beyond the “call of duty” to help ensure Central families have access and support to the
  resources available to them within the partnering organization
- Serves or has served as a change agent within an organization in a way that has had a direct impact on the families within the
  Central community
- Upholds a commitment to community collaboration which remains evident in their daily work
The person I am nominating is a
Name of Nominee *
Please write your reasons for nominating this person as a Champion of Central. *
Responses may range from 100-1,000 words. If easier, you may type your answer in another program and paste it here.
Nominee Contact Information *
Please include e-mail and phone number, if possible.
Your name *
Your Email *
(or preferred contact information)
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms