GENERAL AWARD CATEGORIES -- Official Nomination Form for the TAMHO Awards & Recognition Program

TAMHO Awards and Recognition Program -- 2017 Call for Nominations

This instrument is designed to collect nominations for the General Award categories. The Program of Excellence Award has a separate nomination form [https://www.surveymonkey.com/r/3CDBZYT].

The TAMHO Awards and Recognition Program offers the TAMHO membership an opportunity to recognize and honor remarkable individuals and organizations with the Association’s highest honors. Presented annually, these awards recognize excellence and outstanding achievement within the behavioral health industry. Please block time to review each of the award categories and consider the individuals and events that serve to advance the behavioral healthcare industry.

Question Title

* 1. Please indicate the Award Category and any applicable sub-category(ies) for which this nomination is being submitted for consideration.

Frank G. Clement Community Service Award

Dorothea Dix Professional Service Award

Personal Courage Award

Distinguished Service Award

Media Award

Question Title

* 2. If you selected the TAMHO Media Award category, please indicate for which sub-category the nomination is to be considered.

Print or Electronic Media

Best Use of Social Media

Best Newsletter

Not applicable

Question Title

* 3. NOMINEE INFORMATION

Name

Title

Affiliation

Address

City, State, Zip Code

Telephone

Facsimile

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* 4. NOMINATOR INFORMATION

Name

Title

Affiliation

Address

City, State, Zip Code

Telephone

Facsimile

Question Title

* 5. Please provide an overview, based on the criteria for your chosen award category, of the contributions made by your nominee to support consideration for the award. Personal information (i.e., achievements, community service, offices held, interests, spouse, family, etc.) related to their contribution is welcomed.