Golden Halo Nomination Form
NOMINATIONS ARE DUE JANUARY 13, 2020
AWARDS CELEBRATION TO BE HELD APRIL 24, 2020
Email address *
Best category to describe your nominee *
Name of your nominee *
Your answer
Nominee's address
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Nominee's Agency or Company *
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Nominee's Email *
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What is the nominee’s experience, professional or volunteer, related to the field of child abuse? (maximum of 1,000 characters)
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Please describe how the nominee has made a difference in child abuse prevention, intervention, or advocacy in our community. (maximum of 5,000 characters)
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Describe what makes the nominee’s contribution noteworthy. (maximum of 5,000 characters)
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Please add any additional comments about the nominee that will be helpful in selecting the nominee for an award. (maximum of 2,000 characters)
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If the selection committee needs to ask follow-up questions, would you be available for a brief phone interview? If so, please add your phone number below.
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Nominator's Name
Your answer
Nominator's Address *
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