2026 Immunization Champion Award Nominations Survey

Nominations must be submitted by Nov 13, 2026. Questions? Email heather@immunizear.org

The 2026 Immunization Champion Awards: Immunize Arkansas recognizes individuals, organizations, and providers whose work strengthens immunization efforts across Arkansas. Please use this form to nominate a deserving individual, organization, or provider for one of the awards below.

2025 Award Winners are not eligible for the same awards. The 2025 award winners were:

UAMS Pharmacy Clinical Services - Adult Immunization Champion
Springdale School Nurses- Childhood Immunization Champion
CARTI - Community Partner
Dr. William Greenfield - HPV Superstar

1.Award Nominee Information
If nominating an organization, please provide the organization's name and the primary contact or representative.(Required.)

Name or Organization

If organization - Primary Contact Name

City/Town

Email Address

Phone Number

2.Your Information (Nominator)(Required.)

Name

Company/Organization

City/Town

Email Address

Phone Number

3.Please check the category that best fits the nomination:

The Dr. Laura Williams Award for Outstanding Childhood Immunization- awarded to an individual, organization, or provider who demonstrates exceptional dedication to childhood immunizations. (Immunize Arkansas employees are not eligible)

Outstanding HPV Prevention Champion Award - awarded to an individual, organization, or provider dedicated to raising HPV vaccination rates in Arkansas and educating the community about the HPV vaccine. (Immunize Arkansas employees are not eligible)

Outstanding Adult Immunization Champion - awarded to an individual, organization, or provider who demonstrates exceptional dedication to protecting adults from vaccine-preventable diseases. (Immunize Arkansas employees are not eligible)

Community Partner - awarded to a community organization that demonstrates exceptional dedication to immunizations and furthering the mission of Immunize Arkansas through collaboration and partnership. (Immunize Arkansas employees are not eligible)

4.Tell us about the nominee and their commitment to immunizations.
Describe the nominee's role and how they have demonstrated a commitment to improving immunizations in Arkansas (childhood, adult, or HPV). What activities, programs, or initiatives have they been involved in? Please include specific examples of their work.

For Community Partner nominations: Describe the organization's mission and how its work supports immunizations and aligns with Immunize Arkansas's mission. (Required.)

5.How has the individual or organization made a difference in immunization efforts? Consider activities that have increased vaccination rates, improved access, reduced barriers, strengthened education, or supported communities across Arkansas. Please include specific accomplishments, examples, or measurable results, if known.

For Community Partner nominations: Include how the organization’s involvement has helped better serve communities and improve the health of its community members.(Required.)

6.How has the nominee demonstrated leadership or worked with others?
Describe partnerships, collaborations, workgroups, community activities, education, advocacy, mentoring, or other ways the nominee has helped strengthen immunization efforts.

For Community Partner nominations: Please specifically describe how the organization has partnered on immunization activities, including joint activities, contributions, resources, or ongoing support.(Required.)

7.What makes this nominee deserving of recognition?
What sets this individual or organization apart? Share examples of exceptional dedication, innovative approaches, leadership, or accomplishments that demonstrate their commitment to immunizations.

For Community Partner nominations: Consider the organization’s commitment to collaboration, willingness to contribute time or resources, and efforts that have strengthened immunizations. (Required.)

8.Is there anything else you would like the selection committee to know about this nominee? (not required)