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* 1. Please enter nominator's name

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* 2. Please enter nominator's email address

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* 3. Nominee Name and Pronouns

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* 4. Nominee Email

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* 5. Please enter the Award Category for your nominee

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* 6. Nominee Phone Number

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* 7. Nominee Employer

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* 8. Nominee Job Title

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* 9. Number of Years Nominee involved in the Counseling Profession

To submit your nomination, please complete corresponding questions to the nomination category listed below to provide details in support of the award nominee.

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* 10. Describe the important contribution(s) this nominee has made to the field of Counseling.  Include any other relevant information about the nominee that may assist the committee (250 Words)

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* 11. Describe the contributions of the Graduate Student to the community and the Counseling Profession. Share specific examples of how this Graduate Student has engaged the greater community. Include any other information about the nominee that may assist the committee (250 Words)

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* 12. Describe a Counseling Service or Program within an Organization and explain why this program deserves recognition for excellence.  Provide specific examples why this program is an outstanding organization worthy of recognition.(250 words)

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* 13. Describe how this nominee achieved Diversity, Equity and Inclusion within the Counseling Profession or Community.  Provide specific examples of how this nominee engaged in "good trouble" (250 Words)

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* 14. Describe how this nominee revitalized one of MCA's Divisions.  Give specific examples and name which Division was revitalized this past year. 

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* 15. Please share specific examples how an MCA Member has gone above and beyond to make MCA events successful and in what ways they provided organizational support

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* 16. Please describe how the nominee provided Nominate outstanding volunteer service to the organization and the overall mission of MCA

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* 17. Describe how the nominee demonstrated outstanding community action with details on how they contributed to further the professional identity of counselors, increase access to mental health care, or provide services to an underserved area or population.

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* 18. Please describe what specific actions the MCA member completed through Advocacy efforts at the State or National level that addressed issues of our counseling profession and the clients we serve.

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* 19. Describe in detail how the nominee demonstrates superior clinical excellence, whether in research, teaching or by providing counseling or supervision services and continues to advocate for professional identity development and recognition that counseling. Nominee must have had at least 10 years of experience.

Thank you for your time in submitting a nomination for 2022-23 MCA Awards! Nominees and winners will be notified by April 10th, 2023 and our in person awards ceremony will be held on Saturday, April 22, 2023 at a place and location to be determined.  For more information, please email our awards chair, Dr. Glenda Dickonson at Awards@MDCounseling.org 

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