2017 Circle of Change Awards Nominations Form
Want to help good work get recognized in our community? Send us your nomination!

Awards will be presented at the Circle of Change Awards Dinner April 9, 2016 at the Bearden Banquet Hall

Types of Awards
Danny Mayfield Champion of Change
Presented to a leader in our community who has championed an initiative or campaign whose goal is to change conditions that create injustice.

Institution/Business for Change*
Presented to a business or institution that has implemented an initiative that demonstrates socially conscious business practices in its dealings with the community. *CS Member Groups are NOT eligible for the Institution for Change Award

Campaign for change
Honoring a recent campaign that worked in pursuit of social change, included grassroots support and had a significant impact on a constituency or the community at large.

Seed of Change
Presented to a young person (under age 25) who has shown leadership, vision and courage in addressing injustice.

Gardener of Change
Presented to an educator who teaches their students to think critically about issues of injustice (locally, nationally or internationally) and encourages them to take action.

Artist of Change
Presented to an artist or group of artists (not limited to the visual arts) who uses their art to create social change or demonstrates a connection between their art and social change.

Type of Nomination *
We have 6 different awards (See above) please select which award you would like to make a nomination for
Information about Nominee
Give us as much information as you can about the nominee but even if you don't have all their contact info, please submit the nomination. If your nomination is for the "Campaign for Change" award, give us the name of the campaign. In your description of the campaign, give us any contacts you have.
Name of Nominee or Campaign *
Your answer
Street address, City, State, & Zip Code (of nominee)
Your answer
Phone number (of nominee)
Your answer
Occupation (of nominee)
Your answer
Email (of nominee)
Your answer
Why do you believe this individual, business, or campaign meets the criteria for this specific award?
Your answer
Your information
Your Name
Your answer
Your Address (street, city, state, zip)
Your answer
Your Phone number
Your answer
Your Email
Your answer
Thank You!
Thank you so much for making this nomination. We will let you know if the selection committee picks this nominee. We hope you'll attend the awards dinner which will be held on Saturday, April 9, 2016 at Bearden Banquet Hall.
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