2024 NCICP Award Nominations

2024 National Conference for Immunization Coalitions and Partnerships (NCICP) Award Nominations:

NCICP is excited to host the immunization recognition awards. Please complete the nomination form below to nominate an immunization champion passionate about vaccines and who has worked to increase immunization rates in their community! Please be thorough in your nomination; the recognition committee will use your information to determine the winner. Assume the committee knows nothing about the nominee.

There are five (5) categories (Immunization Leadership, Equity in Immunization, Excellence in Immunization Advocacy, Excellence in Immunization Collaboration, and Emerging Leader); if you would like to nominate more than one person or nominate the same person for multiple awards, please re-submit the form for each nomination. Self-nominations are welcome, and awards will be given at the Philadelphia NCICP Conference. Winners do not need to be present to accept their award (although we’d love to see you in person).

Nominations will be accepted through February 9, 2024

2022 immunization award winners are not eligible for the same award. These award winners are eligible for a different award. The 2022 award winners are listed below:

Immunization Leadership - Erica DeWald
Equity in Immunization - Julissa Soto
Excellence in Immunization Advocacy - Heather Braum
Excellence in Immunization Collaboration - Leisha Anderson
Emerging Leader - Ashlesha Kaushik

If you have any questions about the nomination form or the awards, please email: heather@immunizear.org

Question Title

* 1. Who are you nominating?

Name

Organization/Agency

Role/Title

What state coalition is nominee affiliated?

Address

Address 2

City

Zip

State

Email Address

Phone Number

Question Title

* 2. Category for Nominee (only choose one - if you would like to nominate someone for more than one award, please submit a separate application)

Immunization Leadership Award - Nominee is considered an expert on immunizations in their community. An individual who goes above and beyond or does an exemplary job to promote or foster immunizations. · Activities may include acting as a spokesperson, trainer, mentor or educator.

Equity in Immunization Award - Nominee uses creative or innovative strategies to promote immunization equity or addresses challenges to immunization. Activities may include both new strategies and adapting existing strategies in new ways to reach the under-immunized population.

Excellence in Immunization Advocacy · Nominee is actively advancing policies to support immunization in their community, state, or region. Activities may include but are not limited to providing legislative testimony, building and/or coordinating the development of a group of grassroots advocates, submitting press releases, utilizing social media to educate on bills and deliver a call to action, providing advocacy training, etc.

Excellence in Immunization Collaboration - Nominee is recognized as a collaborator who dedicates their time and talent to build partnerships with community members, organizations, and institutions to build a common agenda to solve complex problems that make a collective impact.

Emerging Leader Award - Nominee is an individual or organization with five (5) years or less experience working in the immunization field who has demonstrated their potential through outstanding service and contributions and has made innovative contributions to their field.

Question Title

* 3. Will the nominee attend the NCICP Conference? (not a requirement to win)

Yes

Unsure

Question Title

* 4. Describe how the nominee fits the criteria for this award. Please include as much information as possible in 250 words or less (no CVs/resumes)

Question Title

* 5. How is the nominee engaged with their coalition? (Limit to 250 words)

Question Title

* 6. Nominator (Your) Information

Name

Organization/Agency

Role/Title

Address

Address 2

City

Zip Code

State

Email Address

Phone Number

Relationship to Nominee

2024 NCICP Award Nominations

Question Title

* 1. Who are you nominating?

Question Title

* 2. Category for Nominee (only choose one - if you would like to nominate someone for more than one award, please submit a separate application)

Question Title

* 3. Will the nominee attend the NCICP Conference? (not a requirement to win)

Question Title

* 4. Describe how the nominee fits the criteria for this award. Please include as much information as possible in 250 words or less (no CVs/resumes)

Question Title

* 5. How is the nominee engaged with their coalition? (Limit to 250 words)

Question Title

* 6. Nominator (Your) Information

Question Title

* 7. Any additional information you would like to add? (Limit 100 words)

Question Title

* 8. If you would like more information about the NCICP Conference, the link is here: NCICP Conference