Nomination Form

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These awards recognize those in our community who consistently share and utilize their skills and talents above and beyond daily expectations to positively impact the lives of others. Please submit all nominations by 10/31/19. As part of this recognition, an honorarium will be given on behalf of each winner to the OSF HealthCare Children's Hospital of Illinois.

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* 1. Please select the award for which you are nominating:

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* 2. Nominee Information:

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* 3. Nominator Information:

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* 4. Please type a summary of the nominee's work with children:

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* 5. How much time has the nominee been involved in this endeavor and what has the level of involvement been:

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* 6. Please provide additional detaild on accomplishments, honors or distinctions:

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* 7. Provide detail on an estimated number of children impacted annually:

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* 8. Please provide additional details on the uniqueness of this endeavor:

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* 9. Please provide any additional comments or details that you believe makes this nominee deserving of this recognition:

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