2020 Health Hero Nomination Form

Purpose:  The Cobb2020 Partnership for Health and the Cobb Chamber recognize qualified individuals and agencies who, through outstanding and dedicated service have made significant positive impact on the health of our community through the Health Hero Award. This award gives recognition to outstanding, significant and innovative activities and accomplishments by an individual or organization.

Nominees must meet the following conditions:
1.  Must provide health and wellness services, support health issues, or support the healthcare workforce in Cobb County.
2.  Must currently live or work in Cobb County. Organizations must have a location in Cobb County.
3.  Must be a member of the Cobb Chamber. For more information on membership, click here.

Instructions: Please complete each area of this form. If an area does not apply, please state “N/A”. You may attach additional information but please limit it to no more than 3 pages. The submission deadline has been extended to August 10th, 2020 at 5PM. For more information or questions, contact Jazmyn McCloud, Cobb Chamber Health and Wellness Committee Member, at jazmyn.mccloud@dph.ga.gov or 770-319-4716.  

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* 1. Would you like to nominate a person or an organization?

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* 2. Nominee Information:

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* 3. Describe the Nominee's related field of work.

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* 4. Describe why the Nominee should be the recipient of the Health Hero Award.  How has the nominee impacted the health of the community, local businesses, or workforce development.

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* 5. What innovative/significant activities or programs has the Nominee contributed?

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* 6. [Optional] Additional Comments:

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* 7. [Optional] Upload attachments:

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
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* 8. Nominator Information

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